Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 71003717 | IL |
Y | 103TC0700X | Clinical Psychologist | 71003717 | IL |
NPI | 1013091016 |
---|---|
Provider Name | Dr. Marlene Brusko |
First Address | Schaumburg, IL 60193-3834 |
Second Address | Schaumburg, IL 60193-3834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 29/05/2011 |