Individual
SHADI MAY BOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
810 N 6TH AVE, PHOENIX, AZ 85003-1318
(602) 625-2529
Mailing address
4201 N 20TH ST UNIT 225, PHOENIX, AZ 85016-5486
(602) 625-2529
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
16954
AZ
101YP2500X
Professional Counselor
Primary
16954
AZ
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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