RICHARD IVY BROUSSARD

SANTA MONICA, CA
NPI1356142210
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2025-03-24
Last Update Date2025-03-24
Business Address
Mr. RICHARD IVY BROUSSARD
907 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
Mailing Address
Mr. RICHARD IVY BROUSSARD
2219 HAUSER BLVD
LOS ANGELES, CA 90016-2015
Phone number: 310-579-1099
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