Individual
MR. UNDRA B BROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA, QMHP
Contact information
Practice address
3242 E MAIN ST, COLUMBUS, OH 43213-3807
(614) 500-4150
Mailing address
3242 E MAIN ST, COLUMBUS, OH 43213-3807
(614) 500-4150
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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