Individual
MS. COURTNEY NICOLE BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
518 N GENERALS BLVD STE D, LINCOLNTON, NC 28092-3537
(704) 748-0616
Mailing address
518 N GENERALS BLVD STE D, LINCOLNTON, NC 28092-3537
(704) 748-0616
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
07/22/2019
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