Individual
MR. CODY PAUL BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
203 E ACADEMY AVE, JENNINGS, LA 70546
(337) 824-1255
Mailing address
203 E ACADEMY AVE, JENNINGS, LA 70546-5331
(337) 824-1255
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/10/2017
Last updated
07/21/2022
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