Frederick Djuan Broussard

NPI 1003112574 - Counselor - 101Y00000X

NPI Details
NPI 1003112574
Gender Male
Enumeration Date 02/01/2011
Last Updated 02/01/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
3707 CHERRY AVE
LONG BEACH CA, 90807-4320, US
Phone (562) 417-9322
Fax
Business Location
3707 CHERRY AVE
LONG BEACH CA, 90807-4320, US
Phone (562) 417-9322
Fax
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Frederick Djuan Broussard NPI is 1003112574, taxonomy code is 101Y00000X Frederick Djuan Broussard physically located at 3707 Cherry Ave, Long Beach CA, 90807-4320. NPI Number Frederick Djuan Broussard has the Individual type.

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1003112574 NPI number is provided on an as is basis without warranty of any kind. 1003112574 is maintained by the National Plan & Provider Enumeration System. The contents of Frederick Djuan Broussard are for informational purposes only.