Most Relevant Information
Provider Data
| NPI Number: | 1003256538 |
| Provider Name: | KAYLA BROUSSARD |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/28/2013 |
| Last Updated: | 06/28/2013 |
Provider Practice Location
2708 NE 14TH ST
STE 5
POMPANO BEACH
FL
330623565
Practice Location Phone/Fax
| Phone: | 8888809270 |
| Fax: |
Provider Mailing Location
58 TUPELO CIR
HAMPTON
VA
236661482
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |