Provider Demographics
NPI:1437309473
Name:BROSCH, PAULA HOWLAND (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:HOWLAND
Last Name:BROSCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:LYNN
Other - Last Name:HOWLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4802 SPERRYVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22749-1704
Mailing Address - Country:US
Mailing Address - Phone:540-987-3174
Mailing Address - Fax:
Practice Address - Street 1:257 GAY STREET
Practice Address - Street 2:ROOM D
Practice Address - City:WASHINGTON
Practice Address - State:VA
Practice Address - Zip Code:22747
Practice Address - Country:US
Practice Address - Phone:540-675-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003913103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical