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MRS. AMY D BROADHURST

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1902175250

Individual Registrant:
MRS. AMY D BROADHURST 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
75 DIAMOND VALLEY RD UNIT C  MARKLEEVILLE, CA 96120-9579 US
Tel: 530-694-1816  Fax: 530-694-2387

Contact information for business:
75 DIAMOND VALLEY RD UNIT C  MARKLEEVILLE, CA 96120-9579 US
Tel: 530-694-1816  Fax: 530-694-2387

Registration Information:
NPI: 1902175250
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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