Individual
MS. DARLENE S BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1811 W DEWITT HENRY DR, BEEBE, AR 72012-2026
(501) 288-1199
(501) 882-3179
Mailing address
897 SHILOH RD, BEEBE, AR 72012-9897
(501) 288-1199
(501) 882-3179
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR751
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155469721
—
AR
01
—
5Y177
BLUE CROSS BLUE SHIELD
AR
Enumeration date
09/15/2006
Last updated
11/11/2010
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