Individual
DANIA BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
1333 COMMON ST, LAKE CHARLES, LA 70601-5255
(337) 437-4014
Mailing address
105 INDUSTRIAL PKWY, LAFAYETTE, LA 70508-3207
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
03/22/2022
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