Broden, Renae A.

Broden, Renae A. is an individual health care provider with primary practice located at 1615 S 17Th St , Grand Forks ND 58201-5354. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Broden, Renae A. can be contacted via phone (701) 795-8550.

Contact Information

Primary practice address
1615 S 17Th St Grand Forks ND 58201-5354
Phone: (701) 795-8550
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 474 North Dakota

Profile Details

NPI number 1902001373
LBN Legal business name Broden, Renae A.
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2007
Last updated May 29th, 2024 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1902001373 NPPES
North Dakota Other 25918 NDBCBS PROVIDER NUMBER

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