Individual
GLORIA BROKENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1318 HIGHWAY 171, STONEWALL, LA 71078-9403
(318) 906-5054
Mailing address
PO BOX 1, GLOSTER, LA 71030-0001
(318) 461-9960
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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