Individual
DR. ELLIOT L BROCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
1250 N 113TH ST STE 200, WAUWATOSA, WI 53226-3209
(262) 432-6600
(262) 432-6604
Mailing address
3384 N 51ST BLVD, MILWAUKEE, WI 53216-3238
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5283-57
WI
103TS0200X
School Psychologist
906-58
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851889901
—
WI
Enumeration date
04/24/2018
Last updated
05/14/2025
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