Provider Demographics
NPI:1376203489
Name:BRODIE, ADINA MIRIAM
Entity Type:Individual
Prefix:MRS
First Name:ADINA
Middle Name:MIRIAM
Last Name:BRODIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SHERRI LN
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1334
Mailing Address - Country:US
Mailing Address - Phone:845-641-0011
Mailing Address - Fax:
Practice Address - Street 1:34 SHERRI LN
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1334
Practice Address - Country:US
Practice Address - Phone:845-642-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst