| NPI | 1992109029 |
|---|---|
| Former Name | STEPHANIE BRODERICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0004103) |
| Additional Taxonomies | 2251H1200X Physical Therapist Hand |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2019-06-17 |