Broaddus, Travis Deonta

Broaddus, Travis Deonta is an individual health care provider with primary practice located at 7135 Minstrel Way Ste 204-M2 , Columbia MD 21045-5255. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Behavior Technician, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Broaddus, Travis Deonta can be contacted via phone (301) 357-0038.

Contact Information

Primary practice address
7135 Minstrel Way Ste 204-M2 Columbia MD 21045-5255
Phone: (301) 357-0038
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1851015077
LBN Legal business name Broaddus, Travis Deonta
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2022
Last updated May 8th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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