Individual
CHARLIE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 ENERGY PKWY, LAFAYETTE, LA 70508-3817
(337) 270-8585
Mailing address
111 ENERGY PKWY, LAFAYETTE, LA 70508-3817
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
LA
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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