Individual
MR. MATTHEW ALEXANDER DECLOUET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
302 LA RUE FRANCE STE 202, LAFAYETTE, LA 70508-3133
(337) 534-0971
(337) 534-0974
Mailing address
302 LA RUE FRANCE STE 202, LAFAYETTE, LA 70508-3133
(337) 534-0971
(337) 534-0974
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP08470
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2411608
—
LA
Enumeration date
07/22/2015
Last updated
04/18/2023
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