Individual
COLETTE BRODERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
507 E COLLEGE ST, IOWA CITY, IA 52240-5115
(319) 338-7884
(319) 338-7006
Mailing address
507 E COLLEGE ST, IOWA CITY, IA 52240-5115
(319) 338-7884
(319) 338-7006
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00716
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07885
MEDICARE ID
IA
Enumeration date
09/25/2006
Last updated
12/18/2007
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