Individual
DR. BRODERICK HARPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
313 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-4119
(609) 498-6009
Mailing address
313 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-4119
(609) 498-6009
(609) 241-6573
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00243700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37LC00243700
SUBSTANCE ABUSE
NJ
Enumeration date
01/11/2018
Last updated
01/11/2018
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