Individual
CHARLES STEWART BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2020 W PINHOOK RD, SUITE 402, LAFAYETTE, LA 70508-3290
(337) 781-6467
Mailing address
2020 W PINHOOK RD, SUITE 402, LAFAYETTE, LA 70508-3290
(337) 781-6467
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104
LA
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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