Provider Demographics
NPI:1427361054
Name:BRODER, FAITH ANN (MA,CCC,SLP)
Entity type:Individual
Prefix:MS
First Name:FAITH
Middle Name:ANN
Last Name:BRODER
Suffix:
Gender:F
Credentials:MA,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-2634
Mailing Address - Country:US
Mailing Address - Phone:336-236-6546
Mailing Address - Fax:336-236-9546
Practice Address - Street 1:440 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-2634
Practice Address - Country:US
Practice Address - Phone:336-236-6546
Practice Address - Fax:336-236-9546
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-25
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10594235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty