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Organization
BROUSSARD MARRIAGE & FAMILY THERAPY INC
Active
Organization
BROUSSARD MARRIAGE & FAMILY THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN ANN BROUSSARD LMFT (CEO)
(619) 607-1234
Entity
Organization
Contact information
Practice address
41661 ENTERPRISE CIR N STE 111, TEMECULA, CA 92590-5629
(619) 607-1234
(951) 527-1401
Mailing address
29042 SILVERDALE LN, WINCHESTER, CA 92596-9616
(619) 607-1234
(951) 527-1401
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
10/24/2022
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