# MR. RICHARD LEO DUBOURG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1962094276
- **Gender:** Man
- **Credential:** PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | 218489 | LA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 218489 | LA | Yes |

## Other

- **Enumeration date:** 02/08/2021
- **Last updated:** 08/30/2023