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Individual

JENNIFER DAWN BROUSSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1505 S OSWEGO AVE, RUSSELLVILLE, AR 72802-2673
(479) 967-3370
(479) 967-2775
Mailing address
100 S CHEROKEE ST, MORRILTON, AR 72110-2656
(501) 354-4589
(501) 354-5410

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
12/04/2008
Last updated
12/04/2008
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Product
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  • Eligibility checks
  • EDI platform