Individual
MARIO BRODEUR-FOSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
3 12TH ST, BERLIN, NH 03570-3860
(603) 752-7404
(603) 752-5194
Mailing address
3 12TH ST, BERLIN, NH 03570-3860
(603) 752-7404
(603) 752-5194
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
424
NH
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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