Individual
DANIEL JOHN BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3528 CHIANTI CIR, MURFREESBORO, TN 37129-4272
(765) 808-1687
Mailing address
3528 CHIANTI CIR, MURFREESBORO, TN 37129-4272
(765) 808-1687
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041132A
IN
103TC1900X
Counseling Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200532030A
—
IN
Enumeration date
08/21/2007
Last updated
01/31/2024
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