Individual
LANIE RENEE BOULLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16733 W LA HWY 700, KAPLAN, LA 70548-6454
(337) 652-1669
Mailing address
16733 W LA HWY 700, KAPLAN, LA 70548-6454
(337) 652-1669
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3197
LA
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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