Individual
JESSICA BROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
75 ENGLEWOOD AVE, WEST HARTFORD, CT 06110-1123
(386) 237-2667
Mailing address
75 ENGLEWOOD AVE, WEST HARTFORD, CT 06110-1123
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3685
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
03/01/2019
Last updated
03/01/2019
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