Individual
TRACY BOUDOIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOT
Contact information
Practice address
32 ANCHORAGE DR, MARRERO, LA 70072-5038
(504) 616-4523
Mailing address
32 ANCHORAGE DR, MARRERO, LA 70072-5038
(504) 616-4523
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTT.Z10725
LA
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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