Provider Demographics
NPI:1164613360
Name:DUFFY-ROBERTS, BROOKE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:DUFFY-ROBERTS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25329 BUDDE RD STE 503
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1695
Mailing Address - Country:US
Mailing Address - Phone:281-374-9485
Mailing Address - Fax:
Practice Address - Street 1:25329 BUDDE RD STE 503
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-1695
Practice Address - Country:US
Practice Address - Phone:281-374-9485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4849101YM0800X
TX15556101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional