Broderick, Daniel John
Broderick, Daniel John is an sole proprietor health care provider with primary practice located at 3528 Chianti Cir , Murfreesboro TN 37129-4272. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Broderick, Daniel John can be contacted via phone (765) 808-1687.Contact Information
Primary practice address
3528 Chianti Cir
Murfreesboro TN 37129-4272
Phone: (765) 808-1687
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counseling | 103TC1900X | ||
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20041132A | Indiana |
Profile Details
NPI number | 1366635518 |
---|---|
LBN Legal business name | Broderick, Daniel John |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 21st, 2007 |
Last updated | Jan 31st, 2024 - about 11 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1366635518 | NPPES |
Indiana | MEDICAID | 200532030A |
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