Provider Information for 1669874772
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KAREN BRODIE LCSW
Sex: Female
NPI: 1669874772
Last Updated: 2020-01-07
Certification Date: 2020-01-07
Certification Date: 2020-01-07
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669874772 | ||||||||||||
| Enumeration Date | 2014-09-19 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1300 CRAVEN ST GREENSBORO, NC 27405-4776 United States Phone: 843-524-8899 | Fax: | ||||||||||||
| Primary Practice Address | 324 T B STANLEY HWY STE B&C BASSETT, VA 24055-6108 United States Phone: 276-629-1076 | Fax:276-629-2695 | ||||||||||||
| Secondary Practice Address(es) | 4944 GREENSBORO RD | ||||||||||||
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