Individual
ANNA RENE BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6625 S RURAL RD, SUITE 111, TEMPE, AZ 85283-3717
(480) 751-1020
Mailing address
PO BOX 24242, TEMPE, AZ 85283
(480) 444-9075
(480) 751-1020
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-12927
AZ
101YP2500X
Professional Counselor
Primary
LPC-12927
AZ
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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