Individual
MS. DORIS S. BROADNAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 S GRAND ST, MONROE, LA 71202-6412
(318) 362-3339
Mailing address
4800 S GRAND ST, MONROE, LA 71202-6412
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1194
LA
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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