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1700505047
TYNISHA M BROUSSARD
FULLERTON, CA
NPI
1700505047
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-08-22
Last Update Date
2022-08-22
Business Address
TYNISHA M BROUSSARD HS
713 W COMMONWEALTH AVE STE C
FULLERTON, CA 92832-1612
Phone number: 714-879-4274
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Mailing Address
TYNISHA M BROUSSARD HS
1919 E 4TH ST APT MGR
LONG BEACH, CA 90802-3818
Phone number: 323-346-7769
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