Individual
TAMMY DORE BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
333 LAFAYETTE ST, GRETNA, LA 70053-5931
(832) 326-4338
Mailing address
333 LAFAYETTE ST, GRETNA, LA 70053-5931
18323264338
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2273
LA
Other
Enumeration date
07/25/2017
Last updated
07/21/2022
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