Mya Broussard
Mya Broussard is a Student in an Organized Health Care Education/Training Program in Pomona, California. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
801 Corporate Center Dr Ste 202Pomona, CA 91768-2627
Phone: (909) 766-7060
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1609602366 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | September 10, 2024 |
| Last updated in NPPES | September 10, 2024 |
| Certification date | September 10, 2024 |
| Mailing address | 801 Corporate Center Dr Ste 202, Pomona, CA 91768-2627 |
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