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General NPI Number Information
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NPI Number | 1629792858
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Entity Type | Individual
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Provider Name | ALLISON BROSCHART ALC
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Gender | Female
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 113 LONGWOOD DR SW STE C
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4511
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Country | US
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Telephone | 256-886-9443
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Fax |
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Provider Business Mailing Address
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Address Line | 1462 PARAMOUNT DR APT 3C
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City | HUNTSVILLE
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State | AL
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Zip | 35806-4805
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Country | US
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Telephone | 803-537-0519
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | ALC04189
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License Number State | AL
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