Individual
DR. JOSHUA JEFFERSON BROMAN-FULKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
222 BIRCH ST, BOONE, NC 28607-5067
(828) 406-1760
(828) 264-6512
Mailing address
222 BIRCH ST, BOONE, NC 28607-5067
(828) 406-1760
(828) 262-2974
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
3587
NC
103TC0700X
Clinical Psychologist
Primary
3587
NC
103TE1100X
Exercise & Sports Psychologist
3587
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069UW
BLUE CROSS BLUE SHIELD NORTH CAROLINA
NC
05
—
6001066
—
NC
Enumeration date
11/01/2006
Last updated
09/14/2010
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