| Doctor Name: | MS. PRISCILLA NA BROUSSARD |
| NPI Number: | 1457679482 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC |
| License Number: | 1475 |
| Business Practice Address: | 2808 S Croatan Hwy Nags Head, NC - 279599024 |
| Business Phone Number: | 2524412324 |
| Business Fax Number: | 2524411994 |
| Mailing Address: | 4300 Sapphire Ct Ste 110, GREENVILLE |
| State: | NC |
| Postal Code: | 278349079 |
| Phone Number: | 2528307540 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2010 |
| NPI Last Update Date: | 12/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1475 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |