Individual
MRS. SHERRY L. BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
215 2ND ST SE, MINOT, ND 58701-3924
(701) 857-4410
Mailing address
215 2ND ST. SE, MINOT, ND 58701
(701) 852-2498
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
517
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
517
ND STATE LICENSE NUMBER
ND
05
—
58531
—
ND
Enumeration date
02/08/2007
Last updated
07/08/2007
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