Provider Demographics
NPI:1578881744
Name:DEBROIZE, LOUIS E (PHD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:E
Last Name:DEBROIZE
Suffix:
Gender:M
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:PO BOX 4272
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13442-4272
Mailing Address - Country:US
Mailing Address - Phone:315-336-0759
Mailing Address - Fax:315-338-5407
Practice Address - Street 1:2202 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5809
Practice Address - Country:US
Practice Address - Phone:315-797-9777
Practice Address - Fax:315-797-9779
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health