| Doctor Name: | DR. BROOKE EGBERT |
| NPI Number: | 1699715110 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PS016379 |
| Business Practice Address: | 317 Vista Dr Shavertown, PA - 187089317 |
| Business Phone Number: | 5706742492 |
| Business Fax Number: | |
| Mailing Address: | 1108 Memorial Hwy, Twin Stacks Center DALLAS |
| State: | PA |
| Postal Code: | 186129178 |
| Phone Number: | 5706741505 |
| Fax Number: | |
| NPI Enumeration Date: | 06/07/2006 |
| NPI Last Update Date: | 04/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | PS016379 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |