Individual
RENAE A. BRODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1615 17TH AVE S, GRAND FORKS, ND 58201-5372
(701) 795-8550
Mailing address
221 CIRCLE HILLS DR, GRAND FORKS, ND 58201-7956
(701) 772-5145
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
474
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25918
NDBCBS PROVIDER NUMBER
ND
Enumeration date
06/18/2007
Last updated
01/19/2026
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