Individual
KELLY BROADFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1909 COMMERCE AVE, CULLMAN, AL 35055-6151
(256) 734-4688
Mailing address
1909 COMMERCE AVE, CULLMAN, AL 35055-6151
(256) 734-4688
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4258
AL
101YM0800X
Mental Health Counselor
C2826A
AL
Other
Enumeration date
02/28/2017
Last updated
11/11/2021
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