Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 808 | LA |
NPI | 1093982787 |
---|---|
Provider Name | Dr. Carmen Dupre Broussard |
First Address | Napoleonville, LA 70390-8728 |
Second Address | Napoleonville, LA 70390-8728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 12/05/2008 |