Individual
JESSICA BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, CCC-SLP, ATP
Contact information
Practice address
2027 10TH ST, GERING, NE 69341-2417
(308) 641-5615
Mailing address
1202 LARKSPUR DR, SCOTTSBLUFF, NE 69361-4513
(308) 641-5615
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1745
NE
Other
Enumeration date
12/15/2015
Last updated
03/17/2018
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