| Sonya Broadus, Lpc Pc | |
|
10654 Us Highway 31 Ste B Spanish Fort AL 36527-8691 | |
| (251) 800-1166 | |
| Not Available |
| Full Name | Sonya Broadus, Lpc Pc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 10654 Us Highway 31 Ste B, Spanish Fort, Alabama |
| Authorized Official Name and Position | Kacy Marie East (OFFICE MANAGER) |
| Authorized Official Contact | 2518001166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sonya Broadus, Lpc Pc 10654 Us Highway 31 Ste B Spanish Fort AL 36527-8691 Ph: (251) 800-1166 | Sonya Broadus, Lpc Pc 10654 Us Highway 31 Ste B Spanish Fort AL 36527-8691 Ph: (251) 800-1166 |
| NPI Number | 1619554623 |
|---|---|
| Provider Enumeration Date | 03/25/2021 |
| Last Update Date | 03/25/2021 |
| Certification Date | 11/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619554623 | NPI | - | NPPES |
| 3403 | Other | AL | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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