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Individual

RYAN EARL BOUDREAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2829 4TH AVE STE 215, LAKE CHARLES, LA 70601-7887
(337) 707-3872
Mailing address
500 BROAD ST # 213, LAKE CHARLES, LA 70601-4335
(337) 707-3872

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PLC10351
LA
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
10/06/2023
Last updated
06/24/2025
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