LISA K BROUSSARD

JASPER, GA
NPI1952045338
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: GA  CSW008306)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: GA  LMSW009255)
Enumeration Date2022-04-22
Last Update Date2023-07-03
Business Address
LISA K BROUSSARD LCSW008306
27 S MAIN ST
JASPER, GA 30143-1600
Phone number: 678-230-5164
Mailing Address
LISA K BROUSSARD LCSW008306
27 S MAIN ST
JASPER, GA 30143-1600
Phone number: 678-230-5164