MS. MARIEILLE JAQUETTE BROADNAX L.P.C.
NPI 1780795104
Counselor - Professional in Detroit, MI

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since August 31, 2006

2051 W GRAND BLVD, DETROIT, MI 48208(313) 961-3700(313) 961-3769 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Ms. Marieille Jaquette Broadnax L.p.c. NPPES

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

MS. MARIEILLE JAQUETTE BROADNAX L.P.C. (NPI 1780795104) is an individual professional provider in Detroit, Michigan, licensed in Michigan (6401008550) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1780795104

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMS. MARIEILLE JAQUETTE BROADNAXCredential: L.P.C.

Location Address2051 W GRAND BLVDDetroit, MI 48208-1105

Mailing Address2051 W Grand BlvdDetroit, MI 48208-1105 · (313) 961-3700 · Fax (313) 961-3769

Phone(313) 961-3700

Fax(313) 961-3769

Sole ProprietorYes

Enumeration DateAugust 31, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1780795104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MI · 6401008550

2051 W GRAND BLVD, Detroit, MI 48208

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Other Identifiers 1

Other6401008550MI · State License

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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