MRS. JENNIFER DIANE BRODERSON L.M.T. - NPI 1437313046

Q: What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

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About Mrs. Jennifer Diane Broderson L.m.t. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JENNIFER DIANE BRODERSON L.M.T. (NPI 1437313046) is an individual specialist in Kailua Kona, Hawaii, licensed in Hawaii (MAT10080) and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1437313046

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameMRS. JENNIFER DIANE BRODERSONCredential: L.M.T.

Location Address74-5620 PALANI RD, SUITE 102Kailua Kona, HI 96740-3640

Mailing Address74-5620 Palani Rd, Suite 102Kailua Kona, HI 96740-3640 · (808) 329-7797 · Fax (808) 329-2748

Phone(808) 329-7797

Fax(808) 329-2748

Sole ProprietorYes

Enumeration DateJuly 12, 2008

✔ NPI 1437313046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in HI · MAT10080

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

74-5620 PALANI RD, Kailua Kona, HI 96740

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