Individual
KENRARD BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
913 S COLLEGE RD STE 105, LAFAYETTE, LA 70503-3061
(337) 534-8433
Mailing address
913 S COLLEGE RD STE 105, LAFAYETTE, LA 70503-3061
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/28/2017
Last updated
03/30/2021
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