Broderick, Jimmy Dean
Broderick, Jimmy Dean is an sole proprietor health care provider with primary practice located at 498 Valley View Dr , Winder GA 30680-1421. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Broderick, Jimmy Dean can be contacted via phone (386) 855-5444.Contact Information
Primary practice address
498 Valley View Dr
Winder GA 30680-1421
Phone: (386) 855-5444
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 19022 | Florida |
Profile Details
| NPI number | 1962070136 |
|---|---|
| LBN Legal business name | Broderick, Jimmy Dean |
| Credentials | MS, LMHC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2021 |
| Last updated | Jun 15th, 2021 - about 3 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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