Individual
LA' TOYA BROUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2865 COUNTY ROAD 413, TYLER, TX 75704-4211
(903) 213-5407
Mailing address
2865 COUNTY ROAD 413, TYLER, TX 75704-4211
(903) 213-5407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
TX
171W00000X
Contractor
—
—
1744R1102X
Research Study Specialist
—
—
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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