MARK SHANNON BROUSSARD

BATON ROUGE, LA
NPI1255833661
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  661)
Enumeration Date2018-03-01
Last Update Date2018-03-01
Business Address
MARK SHANNON BROUSSARD LAC, CCs
5431 SUPERIOR DR
BATON ROUGE, LA 70816-6044
Phone number: 225-964-5000
Mailing Address
MARK SHANNON BROUSSARD LAC, CCs
6421 PERKINS RD STE A
BATON ROUGE, LA 70808-6200
Phone number: 225-924-3000
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