Individual
STEPHANIE KING BOUDREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, PMH-C
Contact information
Practice address
1663 KEED AVE, BATON ROUGE, LA 70806-8138
(225) 978-5713
Mailing address
1663 KEED AVE, BATON ROUGE, LA 70806-8138
(225) 978-5713
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5445
LA
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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