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General NPI Number Information
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NPI Number | 1558288050
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Entity Type | Individual
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Provider Name | VALENCIA BROADUS
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Gender | Female
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Dates
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Enumeration Date | 07/04/2026
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Last Update Date | 07/04/2026
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Provider Practice Location Address
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Address Line | 3720 ARROWHEAD AVE STE 208
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2681
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Country | US
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Telephone | 816-612-1083
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270524
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City | KANSAS CITY
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State | MO
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Zip | 64127-0524
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | MO
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