Mark A. Bromley, ED.S.
Individual provider Active NPI School Psychologist · Clyde, OH
NPI 1043634827 · NPPES record last updated Feb 13, 2014
Key facts
- NPI
- 1043634827
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- OH1370197 (OH)
- Practice address
- 106 S Main St
Clyde, OH 43410-1633 - Phone
- (419) 547-0588
- Fax
- (419) 547-0909
- NPI assigned
- Feb 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OH1370197 | OH | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clyde-Green Springs Exempted Village School District | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | OH1370197 | OH | Yes |
Addresses
Primary practice location
106 S Main St
Clyde, OH 43410-1633
Mailing address
106 S Main St
Clyde, OH 43410-1633
Phone (419) 547-0588
Other providers in Clyde, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.