Individual
MRS. DEANNA JANE BROOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15012 HERONGLEN DR, LITHIA, FL 33547-5853
(813) 684-4191
Mailing address
15012 HERONGLEN DR, LITHIA, FL 33547-5853
(813) 684-4191
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT 1812
FL
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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