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1588175319
DONALD BROUSSARD
BASTROP, LA
NPI
1588175319
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2017-10-19
Last Update Date
2017-10-19
Business Address
DONALD BROUSSARD
644 E JEFFERSON AVE
BASTROP, LA 71220-4619
Phone number: 318-239-3862
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Mailing Address
DONALD BROUSSARD
644 E JEFFERSON AVE
BASTROP, LA 71220-4619
Phone number: 318-239-3862
Copy
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