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Individual

MS. PRISCILLA NA BROUSSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
2808 S CROATAN HWY, NAGS HEAD, NC 27959-9024
(252) 441-2324
(252) 441-1994
Mailing address
4300 SAPPHIRE CT STE 110, GREENVILLE, NC 27834-9079
(252) 830-7540

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1348
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
1475
NC

Other

Enumeration date
05/14/2010
Last updated
12/20/2011
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