MR. John Robert Broussard
NPI #1013271196 in Placerville, California
Provider Information
- NPI Number
- 1013271196
- Entity Type
- Individual
- Name
- MR. John Robert Broussard
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Jul 3, 2012
- Last Updated
- Jul 3, 2012
Practice Location
- Address
- 2711 EDGEWOOD DR
- City
- Placerville
- State
- California
- ZIP Code
- 95667-3409
- Phone
- (530) 306-1816
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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