Provider Demographics
NPI:1861659666
Name:ZALL-CRAWFORD, BROOKE WHITNEY (PSYD)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:WHITNEY
Last Name:ZALL-CRAWFORD
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 1:125 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2052
Mailing Address - Country:US
Mailing Address - Phone:732-780-0803
Mailing Address - Fax:
Practice Address - Street 1:470 ROUTE 79
Practice Address - Street 2:SUITE B-2
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4700
Practice Address - Country:US
Practice Address - Phone:732-513-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4538103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist