Individual
GIONNA BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12042 SE SUNNYSIDE RD # 315, CLACKAMAS, OR 97015-8382
(510) 479-5436
Mailing address
12042 SE SUNNYSIDE RD # 315, CLACKAMAS, OR 97015-8382
(510) 479-5436
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
11/02/2015
Last updated
11/03/2015
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