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Contact Information

LINDA S BROECKL, PhD
4881 SUGAR MAPLE AVE
88 MDOS/SGOW
WRIGHT-PATTERSON AFB, OH45433
 Phone: 937-257-6877
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LINDA S BROECKL · (Female)

NPI Number 1750375697
Status Active
Credentials PhD
Entity Individual
Enumeration date 09/07/2005
Last updated 04/14/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 4970
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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