Individual
DANIEL BROEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1935 W HAYWARD AVE, PHOENIX, AZ 85021-6921
(602) 336-6862
Mailing address
3402 E DESERT COVE AVE, PHOENIX, AZ 85028-2715
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
AZ
Other
Enumeration date
02/09/2007
Last updated
07/26/2007
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