Individual
JUSTIN BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5425 GALERIA DR STE C, BATON ROUGE, LA 70816-8004
(225) 223-6153
Mailing address
5425 GALERIA DR STE C, BATON ROUGE, LA 70816-8004
(225) 223-6153
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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