Individual
LASHALLE BROADNAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
6655 E US HIGHWAY 36, AVON, IN 46123-8923
(888) 714-1927
Mailing address
8092 CAPTAIN DR, AVON, IN 46123-8705
(317) 339-7198
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33012144A
IN
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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