Individual
ANDERSON BROUSSARD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
909 PICO BLVD, SANTA MONICA, CA 90405-1326
(310) 314-6200
Mailing address
909 PICO BLVD, SANTA MONICA, CA 90405-1326
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/13/2016
Last updated
12/28/2016
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