Individual
MISS LAUREN MICHELLE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
671 SW MAIN ST, WINSTON, OR 97496-6571
(541) 492-4550
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 492-4550
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L10925
OR
Other
Enumeration date
09/19/2012
Last updated
03/30/2022
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