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General NPI Number Information
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NPI Number | 1386880276
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Entity Type | Organization
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Legal Business Name | BEVERLY A. BROSKY, PSY.D., PLLC
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 5021 SEMINARY RD SUITE 229
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1945
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Country | US
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Telephone | 703-550-1140
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Fax | 703-575-8090
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Provider Business Mailing Address
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Address Line | 5021 SEMINARY RD SUITE 229
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1945
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Country | US
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Telephone | 703-550-1140
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Fax | 703-575-8090
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | MS. BEVERLY ANN BROSKY
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Credential | PSY.D.
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Telephone | 703-550-1140
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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 |
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License Number State |
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