Individual
LUC G BOUDREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR, QMHP
Contact information
Practice address
6800 SW 105TH AVE STE 101, BEAVERTON, OR 97008-5488
(971) 200-1966
(971) 754-4141
Mailing address
2631 NE 14TH AVE APT 203, WILTON MANORS, FL 33334-4399
(323) 828-0618
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
225X00000X
Occupational Therapist
20859
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20859
OCCUPATIONAL THERAPY
FL
Enumeration date
06/02/2006
Last updated
03/17/2025
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