Bryan Vincent Broussard, RADT1
Counselor, Addiction (Substance Use Disorder) in Sacramento, CA. Individual provider (NPI-1).
NPI number1982167441
StatusActive
Last updated in NPPESApr 11, 2019
Details
- NPI
- 1982167441
- Entity type
- Individual (NPI-1)
- Name
- Bryan Vincent Broussard
- Credential
- RADT1
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2019
- Last updated
- Apr 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
3600 Power Inn RdSacramento, CA 95826-3826
Phone 916-453-2704
Mailing address
3600 Power Inn RdSacramento, CA 95826-3826
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