Individual
FREDERICK DJUAN BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3707 CHERRY AVE, LONG BEACH, CA 90807-4320
(562) 417-9322
Mailing address
3707 CHERRY AVE, LONG BEACH, CA 90807-4320
(562) 417-9322
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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