Individual
MS. SUSAN CLARE BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
11973 CAMP EDEN RD, GOLDEN, CO 80403-8606
(303) 378-6914
(303) 642-7659
Mailing address
11973 CAMP EDEN RD, GOLDEN, CO 80403-8606
(303) 378-6914
(303) 642-7659
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
17755034
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0287715
CDE TEACHER LICENSE
CO
05
—
17755034
—
CO
Enumeration date
04/10/2007
Last updated
07/08/2007
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