Individual
JEAN A BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-3110
(601) 362-6170
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-3110
(601) 362-6170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
47824
MS
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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