Individual
KARISSA BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 JACKSON ST, ALEXANDRIA, LA 71303-2324
(318) 602-0113
Mailing address
1410 DONAHUE FERRY RD, PINEVILLE, LA 71360-5146
(318) 450-9513
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13922
LA
Other
Enumeration date
02/08/2022
Last updated
07/07/2023
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