MEDICARE: MS. SEKAI DENARD BROADEN LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	6301007836	MI

General Provider Information

NPI Number	:	1750610796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SEKAI DENARD BROADEN LLP

Provider Business Mailing Address
First Line	:	14952 ROSEMONT AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48223-2364
Country	:	US
Telephone Number	:	313-492-2765
Fax Number	:

Provider Business Practice Location Address
First Line	:	14952 ROSEMONT AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48223-2364
Country	:	US
Telephone Number	:	313-492-2765
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2009
Last Update Date	:	12/22/2009

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