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General NPI Number Information
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NPI Number | 1316596091
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Entity Type | Individual
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Provider Name | BROOKE ELIZABETH DEBOY PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 7047 E GREENWAY PKWY STE 250
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-8113
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Country | US
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Telephone | 480-567-9771
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Fax |
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Provider Business Mailing Address
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Address Line | 5003 W PEDRO LN
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City | LAVEEN
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State | AZ
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Zip | 85339-4226
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Country | US
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Telephone | 602-790-5542
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-005164
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License Number State | AZ
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