Individual
AIMEE BROUSSARD LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, LOTR
Contact information
Practice address
108 ENERGY PKWY, LAFAYETTE, LA 70508-3818
(337) 504-4244
Mailing address
103 BAKER ST, BROUSSARD, LA 70518-5417
(337) 258-5883
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
307044
LA
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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