Individual
ZOE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
628 COMMERCIAL PKWY STE 2, WEST MONROE, LA 71292-8062
(318) 588-8908
(318) 588-8909
Mailing address
PO BOX 1823, WEST MONROE, LA 71294-1823
(318) 588-8908
(318) 588-8909
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R-12592
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-23-257481
BACB
LA
Enumeration date
09/14/2023
Last updated
09/14/2023
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