National Provider Identifier
Matthew Broad, LCAT
Matthew Broad, LCAT is listed in the NPPES registry with a primary specialty of Art Therapist in Rochester, NY and a listed phone number of (585) 451-0028.
Profile Overview
- NPI
- 1912505249
- Provider Type
- Individual
- Primary Specialty
- Art Therapist
- Enumeration Date
- October 09, 2020
- Last Updated
- October 09, 2020
Practice Location
- 1 Mustard St Ste 240250
- Rochester, NY 14609-6980
Phone: (585) 451-0028
Mailing Address
- 227 S Union St
- Spencerport, NY 14559-1403
Specialties
- Art Therapist (221700000X)
Full Record
- NPI
- 1912505249
- Entity Type
- Individual
- Last Name
- Broad
- First Name
- Matthew
- Name Prefix
- Mr.
- Credential
- LCAT
- Mailing Street Address
- 227 S Union St
- Mailing City
- Spencerport
- Mailing State
- NY
- Mailing ZIP Code
- 14559-1403
- Mailing Country
- US
- Mailing Phone
- (585) 451-0028
- Mailing Fax
- (585) 654-1718
- Practice Street Address
- 1 Mustard St Ste 240250
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14609-6980
- Practice Country
- US
- Practice Phone
- (585) 451-0028
- Practice Fax
- (585) 654-1718
- Enumeration Date
- October 09, 2020
- Last Updated
- October 09, 2020
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- October 09, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Art Therapist (221700000X)