Provider Demographics
NPI:1023203023
Name:HERSH, BROOKE (PHD)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:HERSH
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 1:8202 CORNERWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717
Mailing Address - Country:US
Mailing Address - Phone:512-550-8305
Mailing Address - Fax:
Practice Address - Street 1:7700 CAT HOLLOW DR
Practice Address - Street 2:SUITE 206
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5796
Practice Address - Country:US
Practice Address - Phone:512-807-8457
Practice Address - Fax:512-501-2259
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36147103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily