Organization
STEPHAN BROOKENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN SAFON BROOKENS M.S (LICENSED BEHAVIOR SPECIALIST)
(484) 938-8732
Entity
Organization
Contact information
Practice address
1554 E WALNUT LN, PHILADELPHIA, PA 19138-1608
(484) 938-8732
Mailing address
1554 E WALNUT LN, PHILADELPHIA, PA 19138-1608
(484) 938-8732
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH001289
PA
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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