Healthcare Provider Details

I. General information

NPI: 1932323516
Provider Name (Legal Business Name): KAREN L BROZIK MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 N 113TH AVE SUITE C-19
YOUNGTOWN AZ
85363-1162
US

IV. Provider business mailing address

PO BOX 7996
SURPRISE AZ
85374-0116
US

V. Phone/Fax

Practice location:
  • Phone: 928-617-0077
  • Fax:
Mailing address:
  • Phone: 928-671-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-11742
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: