Individual
MELISSA RANDALL BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
8585 PICARDY AVE, BATON ROUGE, LA 70809-3748
(225) 763-4867
Mailing address
18348 THREE BARS DR, BATON ROUGE, LA 70817-0707
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10573
LA
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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