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General NPI Number Information
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NPI Number | 1215446695
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Entity Type | Organization
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Legal Business Name | BROOKE LAUFER PLLC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 826 MADISON ST
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City | EVANSTON
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State | IL
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Zip | 60202
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Country | US
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Telephone | 847-440-7361
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Fax |
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Provider Business Mailing Address
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Address Line | 826 MADISON ST
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City | EVANSTON
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State | IL
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Zip | 60202
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Country | US
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Telephone | 847-440-7361
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | DR. BROOKE RADDER LAUFER
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Credential | PSY.D.
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Telephone | 917-558-5178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071007717
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License Number State | IL
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