Individual
MRS. ASHLEY PATRICE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1723 KRESKY AVE, CENTRALIA, WA 98531-8985
(360) 559-6201
Mailing address
1723 KRESKY AVE, CENTRALIA, WA 98531-8985
(360) 559-6201
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG 60714499
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4155
AK
Other
Enumeration date
04/27/2017
Last updated
07/25/2019
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