Individual
JENNIFER BROADDUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
11376 BARLEY FIELD WAY, MARRIOTTSVILLE, MD 21104-1339
(443) 472-5791
Mailing address
11376 BARLEY FIELD WAY, MARRIOTTSVILLE, MD 21104-1339
(443) 472-5791
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0583C
MD
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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