| NPI | 1609305952 | 
|---|---|
| Professional Name | STEPHANIE BROADNAX BROUSSARD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 57261) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 57261) | 
| Enumeration Date | 2017-06-09 | 
| Last Update Date | 2022-05-27 |