Individual
BRYAN VINCENT BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT1
Contact information
Practice address
3600 POWER INN RD, SACRAMENTO, CA 95826-3826
(916) 453-2704
Mailing address
3600 POWER INN RD, SACRAMENTO, CA 95826-3826
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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