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Shanika Broussard
NPI 1265034516 · on the registry since 2020
Practice
- Address
- 6163 E Lamar St
Bay Saint Louis, MS 39520 - Phone
- (504) 908-5893
- Organisation at this address
- Tsaleach Lab Solutions Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- Adult Companion
372600000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-11-11
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 Mississippi