Individual
DEJAE ANTRELL BROOMFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 PROGRESSIVE BLVD, HOUMA, LA 70360-4069
(985) 303-6090
(985) 872-0985
Mailing address
320 PROGRESSIVE BLVD, HOUMA, LA 70360-4069
(985) 303-6090
(985) 872-0985
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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