Individual
JESSIE M BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
1322 ELTON RD, SUITE I, JENNINGS, LA 70546-4100
(337) 824-5488
Mailing address
1322 ELTON RD, SUITE I, JENNINGS, LA 70546-4100
(337) 824-5488
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
200283
LA
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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