Individual
KELLY MICHELLE BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
190 KEAWE ST STE 33, HILO, HI 96720-2849
(808) 238-9990
Mailing address
7006 W BRIARWOOD AVE, WICHITA, KS 67212-2928
(808) 238-9990
(808) 865-2930
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC-790
HI
Other
Enumeration date
02/22/2019
Last updated
10/03/2024
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