Individual
KATHRYN BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 HOSPITAL DR, YORK, ME 03909-1099
(207) 363-4321
(207) 351-2216
Mailing address
15 HOSPITAL DR, YORK, ME 03909-1099
(207) 351-2478
(207) 351-2216
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
ST2783
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ST2783
LICENSE
ME
Enumeration date
03/23/2018
Last updated
03/23/2018
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