| Doctor Name: | DR. EVAN MCBROOM |
| NPI Number: | 1235520263 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 7272 |
| Business Practice Address: | 8040 Corporate Cir Suite #4 North Royalton, OH - 441331282 |
| Business Phone Number: | 4197044769 |
| Business Fax Number: | |
| Mailing Address: | 8040 Corporate Cir, Suite #4 NORTH ROYALTON |
| State: | OH |
| Postal Code: | 441331282 |
| Phone Number: | 4197044769 |
| Fax Number: | |
| NPI Enumeration Date: | 02/12/2015 |
| NPI Last Update Date: | 02/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 7272 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |