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General NPI Number Information
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NPI Number | 1770952483
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Entity Type | Individual
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Provider Name | BERNADETTE HARRIS-BRODI M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 11325 LAWNDELL RD SW
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City | NAVARRE
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State | OH
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Zip | 44662-8804
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Country | US
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Telephone | 818-794-7761
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 345
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City | NAVARRE
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State | OH
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Zip | 44662-0345
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Country | US
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Telephone | 941-201-2631
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M1200015
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License Number State | OH
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