Individual
DR. BRAD STEPHEN BROEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1266 FIRST STREET, SUITE #11, SARASOTA, FL 34236-5519
(941) 953-6804
(941) 953-3704
Mailing address
1266 FIRST STREET, SUITE #11, SARASOTA, FL 34236-5519
(941) 953-6804
(941) 953-3704
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
PY-5583
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY-5583
FL
103TC0700X
Clinical Psychologist
Primary
PY-5583
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY-5583
FL
103TF0000X
Family Psychologist
PY-5583
FL
103TF0200X
Forensic Psychologist
PY-5583
FL
Other
Enumeration date
08/29/2008
Last updated
08/29/2008
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