Individual
SAMANTHA BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW, LMSW
Contact information
Practice address
1140 3RD ST NE, WASHINGTON, DC 20002-6274
(202) 873-9071
Mailing address
713 FORSTON ST, TAKOMA PARK, MD 20912-7332
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LG50082665
DC
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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