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Individual

SHAELYN BROUSSARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1710 PLAZA WAY, WALLA WALLA, WA 99362-4362
(509) 529-4218
Mailing address
223 N COLLEGE AVE APT B, COLLEGE PLACE, WA 99324-1047

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
11/09/2018
Last updated
11/09/2018
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