KELLY R. BRODERICK

LA GRANGE, IL
NPI1881817443
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101Y00000X Counselor
(Licence: IL  178-000705)
Additional Taxonomies222Q00000X Developmental Therapist
(Licence: IL  178-000705)
Enumeration Date2007-04-11
Last Update Date2007-07-08
Business Address
Mrs. KELLY R. BRODERICK L.P.C.
515 S ASHLAND AVE
LA GRANGE, IL 60525-2812
Phone number: 708-352-1880
Mailing Address
Mrs. KELLY R. BRODERICK L.P.C.
515 S ASHLAND AVE
LA GRANGE, IL 60525-2812
Phone number: 708-352-1880