Individual
DR. JAMES BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1000 HIGHLAND COLONY PKWY STE 5203, RIDGELAND, MS 39157-2079
(601) 809-5324
Mailing address
1000 HIGHLAND COLONY PKWY STE 5203, RIDGELAND, MS 39157-2079
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
591036
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/11/2011
Last updated
12/17/2020
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