Individual
MADELEINE MARIE BARBARA BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1617 METAIRIE RD, METAIRIE, LA 70005-3976
(504) 481-7359
(888) 512-6130
Mailing address
1617 METAIRIE RD, METAIRIE, LA 70005-3976
(504) 481-7359
(888) 512-6130
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-672
LA
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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