Individual
BRENDA LEANNE BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3003 DAWN DR STE 101, GEORGETOWN, TX 78628-2800
(512) 688-4303
Mailing address
5293 S 31ST ST STE 137, TEMPLE, TX 76502-3575
(512) 688-4303
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
66924
TX
101YP2500X
Professional Counselor
Primary
66924
TX
Other
Enumeration date
11/15/2020
Last updated
11/15/2020
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