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Individual

SHAMEECA BROUSSARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
138 GALLIAN ST, LAFAYETTE, LA 70501-6425
(337) 422-7871
(337) 770-2696
Mailing address
PO BOX 91246, LAFAYETTE, LA 70509-1246
(337) 422-7871
(337) 770-2696

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
LA

Other

Enumeration date
09/01/2025
Last updated
09/01/2025
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