| Doctor Name: | MS. CAROL ANN BRODA |
| NPI Number: | 1164577177 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MED LPC |
| License Number: | 37PC00337800 |
| Business Practice Address: | 105 Hamburg Turnpike Pompton Lakes, NJ - 07442 |
| Business Phone Number: | 9738310613 |
| Business Fax Number: | 9738310957 |
| Mailing Address: | 21 Evans Place, C/o New Bridge Services Inc POMPTON PLAINS |
| State: | NJ |
| Postal Code: | 07444 |
| Phone Number: | 9739072700 |
| Fax Number: | 9738394770 |
| NPI Enumeration Date: | 01/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37PC00337800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |