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Contact Information

KIMBERLY BROUSSARD
3380 E RUSSELL RD
SUITE 104
LAS VEGAS, NV89120-3402
 Phone: 702-476-0448
 Fax: 702-476-0449
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
 

Behavior Analyst

103K00000X
Indicates primary specialty

NPI Profile & details for KIMBERLY BROUSSARD

NPI Number 1477908275
LBN Legal business name KIMBERLY BROUSSARD
Authorized official KIMBERLY BROUSSARD - (OWNER / OPERATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/28/2016
Last updated 04/29/2016 - About 10 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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