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1003112574
FREDERICK DJUAN BROUSSARD
LONG BEACH, CA
NPI
1003112574
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2011-02-01
Last Update Date
2011-02-01
Business Address
-- FREDERICK DJUAN BROUSSARD
3707 CHERRY AVE
LONG BEACH, CA 90807-4320
Phone number: 562-417-9322
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Mailing Address
-- FREDERICK DJUAN BROUSSARD
3707 CHERRY AVE
LONG BEACH, CA 90807-4320
Phone number: 562-417-9322
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