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Individual

DR. LINDA SUSAN BROECKL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
4881 SUGAR MAPLE AVE, 88 MDOS/SGOW, WPAFB, OH 45433
(937) 257-6877
Mailing address
4881 SUGAR MAPLE AVE, 88 MDOS/SGOW, WPAFB, OH 45433
(937) 257-6877

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4970
OH

Other

Enumeration date
09/07/2005
Last updated
04/14/2015
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