Individual
MRS. AMY D BROADHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 DIAMOND VALLEY RD UNIT C, MARKLEEVILLE, CA 96120-9579
(530) 694-1816
(530) 694-2387
Mailing address
75 DIAMOND VALLEY RD UNIT C, MARKLEEVILLE, CA 96120-9579
(530) 694-1816
(530) 694-2387
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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