Individual
MRS. MARY ELIZABETH BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A., B.S.
Contact information
Practice address
107 BRIARMEADOW DR, LAFAYETTE, LA 70508-7210
(337) 857-1331
Mailing address
107 BRIARMEADOW DR, LAFAYETTE, LA 70508-7210
(337) 857-1331
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11181
LA
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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