Individual
MRS. KELLY R. BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
515 S ASHLAND AVE, LA GRANGE, IL 60525-2812
(708) 352-1880
(708) 352-1880
Mailing address
515 S ASHLAND AVE, LA GRANGE, IL 60525-2812
(708) 352-1880
(708) 352-1880
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
222Q00000X
Developmental Therapist
—
IL
Other
Enumeration date
04/11/2007
Last updated
09/11/2025
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