Provider Demographics
NPI:1417069493
Name:BROSKY, BEVERLY ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:ANN
Last Name:BROSKY
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 1:5021 SEMINARY RD
Mailing Address - Street 2:SUITE 229
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1945
Mailing Address - Country:US
Mailing Address - Phone:703-550-1140
Mailing Address - Fax:703-575-8090
Practice Address - Street 1:5021 SEMINARY RD
Practice Address - Street 2:SUITE 229
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1945
Practice Address - Country:US
Practice Address - Phone:703-550-1140
Practice Address - Fax:703-575-8090
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003083103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical