Individual
MARK BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
239 NASHVILLE AVE, NEW ORLEANS, LA 70115-2108
(435) 491-0531
Mailing address
239 NASHVILLE AVE, NEW ORLEANS, LA 70115-2108
(435) 491-0531
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12716
LA
Other
Enumeration date
01/25/2016
Last updated
05/19/2022
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