Organization
BROOKE E. EGBERT, PSY.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROOKE E EGBERT PSY.D. (CLINICAL PSYCHOLOGIST)
(570) 899-8902
Entity
Organization
Contact information
Practice address
1325 N RIVER ST, SUITE 206, PLAINS, PA 18702-1838
(570) 899-8902
(570) 824-5417
Mailing address
317 VISTA DR, SHAVERTOWN, PA 18708-9317
(570) 899-8902
(570) 824-5417
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS016379
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102470878 0003
—
PA
Enumeration date
03/14/2013
Last updated
03/14/2013
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