Individual
GRETCHEN SMITH BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1011 N CAUSEWAY BLVD STE 25, MANDEVILLE, LA 70471-3282
(985) 626-8403
Mailing address
133 BUTTERNUT LN, MANDEVILLE, LA 70448-1097
(504) 236-0473
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5165
LA
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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