Individual
AJAH BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
921 S IBERIA ST, NEW IBERIA, LA 70560-5534
(337) 380-8169
Mailing address
921 S IBERIA ST, NEW IBERIA, LA 70560-5534
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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