Individual
MICHELLE BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2103 AGECROFT RD, VIRGINIA BEACH, VA 23454-5825
(757) 754-6980
Mailing address
2103 AGECROFT RD, VIRGINIA BEACH, VA 23454-5825
(757) 754-6980
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003837
VA
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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