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Individual

MS. CONNIE PEARL BROUSSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LMSW

Contact information

Practice address
302 DULLES DR, SUITE 1, LAFAYETTE, LA 70506-3008
(337) 262-5870
(337) 262-1272
Mailing address
302 DULLES DR, SUITE 1, LAFAYETTE, LA 70506-3008
(337) 262-5870
(337) 262-1272

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCSW 9124
LA
1041C0700X
Clinical Social Worker
LMSW 9124
LA

Other

Enumeration date
02/19/2008
Last updated
02/13/2012
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