Individual
EVAN J BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, PLPC
Contact information
Practice address
850 KALISTE SALOOM RD STE 219, LAFAYETTE, LA 70508-4230
(337) 504-4974
Mailing address
7323 CEMETARY HWY, SAINT MARTINVILLE, LA 70582-7903
(337) 380-9989
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PLC8587
LA
Other
Enumeration date
05/24/2021
Last updated
05/26/2021
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