Otis Nmn Broome Jr.
Marriage & Family Therapist in Pasadena, CA. Individual provider (NPI-1).
NPI number1164077830
StatusActive
Last updated in NPPESSep 25, 2019
Details
- NPI
- 1164077830
- Entity type
- Individual (NPI-1)
- Name
- Otis Nmn Broome Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 8, 2019
- Last updated
- Sep 25, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | – | – | Yes |
Practice location
100 W Walnut St Ste 375Pasadena, CA 91124-0001
Phone 626-395-7100
Mailing address
100 W Walnut St Ste 375Pasadena, CA 91124-0001
Phone 626-395-7100
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