Individual
LAURIE A BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5308 HARROUN RD STE 280, SYLVANIA, OH 43560-2190
(567) 585-2080
(567) 585-2081
Mailing address
5308 HARROUN RD STE 280, SYLVANIA, OH 43560-2190
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003687RX
OH
363A00000X
Physician Assistant
Primary
50003687
OH
363A00000X
Physician Assistant
PA.200277
LA
Other
Enumeration date
06/24/2009
Last updated
03/13/2026
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