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1194735159
LOUIS BROUSSEAU
FLAGSTAFF, AZ
NPI
1194735159
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AZ 2588)
Enumeration Date
2006-08-09
Last Update Date
2007-07-08
Business Address
-- LOUIS BROUSSEAU MA
2187 N VICKEY ST
FLAGSTAFF, AZ 86004-6106
Phone number: 928-714-6401
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Mailing Address
-- LOUIS BROUSSEAU MA
2187 N VICKEY ST
FLAGSTAFF, AZ 86004-6106
Phone number: 928-714-6401
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