Broll, Lorraine T
Broll, Lorraine T is an individual health care provider with primary practice located at 7633 Ganser Way Ste 204, Madison WI 53719-2092. She recently has only one registered license in Behavioral Health & Social Service Providers / Family, which is considered as her primary health care specialty. Broll, Lorraine T can be contacted via phone (608) 829-1800.Contact Information
Primary practice address
7633 Ganser Way Ste 204
Madison WI 53719-2092
Phone: (608) 829-1800
Fax: (608) 829-1885
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Family | 103TF0000X | 1106057 | Wisconsin |
Profile Details
| NPI number | 1649210360 |
|---|---|
| LBN Legal business name | Broll, Lorraine T |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649210360 | NPPES |
| Wisconsin | MEDICAID | 39048000 |
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