Sarah Broderick, Ed.S., NCSP
Psychologist, School in Portland, OR. Individual provider (NPI-1).
NPI number1265327894
StatusActive
Last updated in NPPESJun 12, 2025
Details
- NPI
- 1265327894
- Entity type
- Individual (NPI-1)
- Name
- Sarah Broderick
- Credential
- Ed.S., NCSP
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2025
- Certification date
- Jun 12, 2025
- Last updated
- Jun 12, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TS0200X | Psychologist, School | 523090 | OR | Yes |
Practice location
7200 Ne 11th AvePortland, OR 97211-4096
Phone 503-916-6282
Mailing address
7200 Ne 11th AvePortland, OR 97211-4096
Phone 503-916-6282
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