Individual
DESIREE BROUILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFM03594
Contact information
Practice address
78A VERSAILLES BLVD, ALEXANDRIA, LA 71303-3960
(318) 619-7772
(318) 619-1101
Mailing address
78A VERSAILLES BLVD, ALEXANDRIA, LA 71303-3960
(318) 619-7772
(318) 619-1101
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
CFM03594
LA
Other
Enumeration date
04/16/2026
Last updated
04/16/2026
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