Search › Georgia › 1041C0700X
Lisa Broussard, LCSW008306
NPI 1952045338 · on the registry since 2022 · sole proprietor
Practice
- Address
- 27 S Main St
Jasper, GA 30143 - Phone
- (678) 230-5164
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YM0800X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-07-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia