person
Ms. Marieille Jaquette Broadnax, LPC
Professional Counselor in Detroit, Michigan
NPI 1780795104

Marieille Jaquette Broadnax is a Professional Counselor based in Detroit, MI and is specialized in Professional. Marieille Jaquette Broadnax practices in Detroit, MI and has the professional credentials of LPC. The NPI Number for Marieille Jaquette Broadnax is 1780795104 and holds a License No. 6401008550 (Michigan).

The current practice location address for Marieille Jaquette Broadnax is 2051 W Grand Blvd, Detroit, MI and can be reached out via phone at 313-961-3700 and via fax at 313-961-3769. You can also correspond with Marieille Jaquette Broadnax through the mailing address at 2051 W GRAND BLVD, DETROIT, MI - 48208-1105 (mailing address contact number: 313-961-3700).

Location: 2051 W Grand Blvd, Detroit, MI, 48208-1105
person
Provider Profile Details
NPI Number
1780795104
Provider Name
Marieille Jaquette Broadnax
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
2051 W Grand Blvd, Detroit, MI, 48208-1105
Phone Number
313-961-3700
Fax Number
313-961-3769
Provider Enumeration Date
08/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6401008550 01 MI STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
2051 W Grand Blvd
City
State
Zip
48208-1105
Phone Number
313-961-3700
Fax Number
313-961-3769
person
Provider Business Mailing Address Details
Address
2051 W Grand Blvd
City
State
Zip
48208-1105
Phone Number
313-961-3700
Fax Number
313-961-3769
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
6401008550 (Michigan)
Definition
Definition to come...
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