Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JUSTIN TYLER BROUSSARD
Active Sole ProprietorJUSTIN TYLER BROUSSARD is a Mental Health Counselor healthcare provider located in SAN LOUIS OBISPO, California. NPI 1326310632 is currently active in the NPPES registry. Verify at CMS.
Mental Health Counselor · SAN LOUIS OBISPO, CA
Registration Details
- NPI Number
- 1326310632
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 1, 2012 (14.512222473421 yrs)
- Last Updated
- Jan 27, 2014
- Sole Proprietor
- Yes
Practice Information
- Address
-
3765 S. HIGUERASUITE 100SAN LOUIS OBISPO, CA, 93401Browse CA providers · Browse ZIP 93401
- Phone
- 8057813535
- Fax
- 8055036499
- Primary Specialty
-
Mental Health Counselor
101YM0800X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.