Provider Demographics
NPI:1316596091
Name:DEBOY, BROOKE ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:DEBOY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 W PEDRO LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-4226
Mailing Address - Country:US
Mailing Address - Phone:602-790-5542
Mailing Address - Fax:
Practice Address - Street 1:7047 E GREENWAY PKWY STE 250
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-8113
Practice Address - Country:US
Practice Address - Phone:480-567-9771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005164103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist