Individual
MS. COURTNEY NICOLE BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
215 W 3RD AVE, GASTONIA, NC 28052-4058
(704) 866-6160
Mailing address
215 W 3RD AVE, GASTONIA, NC 28052-4058
(704) 866-6160
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13681
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14171686
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
Enumeration date
07/22/2019
Last updated
05/27/2026
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