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1073969218
CHARLES STEWART BROUSSARD
LAFAYETTE, LA
NPI
1073969218
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA 104)
Enumeration Date
2016-05-06
Last Update Date
2016-05-06
Business Address
-- CHARLES STEWART BROUSSARD LAC
2020 W PINHOOK RD SUITE 402
LAFAYETTE, LA 70508-3290
Phone number: 337-781-6467
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Mailing Address
-- CHARLES STEWART BROUSSARD LAC
2020 W PINHOOK RD SUITE 402
LAFAYETTE, LA 70508-3290
Phone number: 337-781-6467
Copy
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