# PATTIE S BRODERICK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1174804090
- **Gender:** F
- **Credential:** LISW, CP/AP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 1305 | SC | Yes |

## Other

- **Enumeration date:** 09/06/2011
- **Last updated:** 09/06/2011