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1356124457
STEPHANIE BROUSSARD
PORTLAND, OR
NPI
1356124457
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
Enumeration Date
2023-08-14
Last Update Date
2024-07-05
Business Address
STEPHANIE BROUSSARD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 210-500-1222
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Mailing Address
STEPHANIE BROUSSARD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 210-500-1222
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