Individual
SHANNON BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
529 SE 2ND ST STE D, LEES SUMMIT, MO 64063-2654
(816) 581-3737
(816) 581-3738
Mailing address
529 SE 2ND ST STE D, LEES SUMMIT, MO 64063-2654
(816) 581-3737
(816) 581-3738
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10002
KS
104100000X
Social Worker
Primary
2016027520
MO
Other
Enumeration date
07/09/2016
Last updated
05/04/2017
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