Individual
MALLORY RENEE BOREL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
108 RUE LOUIS XIV, LAFAYETTE, LA 70508-5739
(337) 235-8007
(337) 235-8008
Mailing address
10534 RIDGEBROOK AVE, BATON ROUGE, LA 70809-4026
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
05/17/2024
Last updated
01/21/2026
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