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Individual

DR. MARC B BOURGEOIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1011 HARDING ST., LAFAYETTE, LA 70503
(337) 501-2624
(337) 482-6747
Mailing address
112 ALMA DR, BROUSSARD, LA 70518-4787
(337) 501-2624
(337) 482-6747

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4930
LA

Other

Enumeration date
03/21/2011
Last updated
03/21/2011
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