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Roosevelt Broach
Mental Health Counselor in Dallas, Texas
NPI 1083280374

Roosevelt Broach is a Mental Health Counselor based in Rockwall, TX and is specialized in Mental Health. Roosevelt Broach practices in Dallas, TX. The NPI Number for Roosevelt Broach is 1083280374 and holds a License No. 79180 (Texas).

The current practice location address for Roosevelt Broach is 12959 Jupiter Rd Ste 140, Dallas, TX and can be reached out via phone at 214-221-0132.

Location: 12959 Jupiter Rd Ste 140, Dallas, TX, 75087-8721
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083280374
Provider Name
Roosevelt Broach
Credential
Provider Entity Type
Individual
Gender
Male
Address
12959 Jupiter Rd Ste 140, Dallas, TX, 75087-8721
Phone Number
214-221-0132
Fax Number
Provider Enumeration Date
05/27/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12959 Jupiter Rd Ste 140
City
Dallas
State
Texas
Zip
75238-3200
Phone Number
214-221-0132
Fax Number
person
Provider Business Mailing Address Details
Address
12959 Jupiter Rd Ste 140
City
Dallas
State
Texas
Zip
75238-3200
Phone Number
214-221-0132
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
79180 (Texas)
Definition
Definition to come...
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