Individual
CAROL BRODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 WAITE ST, REVERE, MA 02151-2400
(781) 286-5090
Mailing address
108 WAITE ST, REVERE, MA 02151-2400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
113784-SW-LICSW
MA
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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