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General NPI Number Information
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NPI Number | 1194518787
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Entity Type | Individual
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Provider Name | MADISON INNES BRODOSKI M.A., CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1161 E CLARK RD STE 360-A
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City | DEWITT
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State | MI
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Zip | 48820-7930
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Country | US
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Telephone | 517-507-5525
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Fax | 517-507-3085
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Provider Business Mailing Address
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Address Line | 1060 AARON DR APT 307
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City | DEWITT
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State | MI
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Zip | 48820-7974
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Country | US
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Telephone | 313-600-6394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7152001145
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License Number State | MI
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