Individual
MS. LORI ANN BOUDREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., M.ED, LPC-MHSP
Contact information
Practice address
423 MEDICAL PARK DR STE 400, LENOIR CITY, TN 37772-5641
(865) 271-6545
Mailing address
4420 WHITTLE SPRINGS ROAD, STE B, KNOXVILLE, TN 37917
(865) 688-0661
(865) 688-5780
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC0000002116
TN
101YP2500X
Professional Counselor
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530582
—
TN
Enumeration date
05/10/2007
Last updated
04/28/2020
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