Individual
DR. MARYELIZABETH FORMAN LEBOEUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1651 THIBODEAUX AVE STE A, BATON ROUGE, LA 70806-8271
(225) 267-7763
(855) 398-6697
Mailing address
1651 THIBODEAUX AVE STE A, BATON ROUGE, LA 70806-8271
(225) 267-7763
(855) 398-6697
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
975
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2128850
—
LA
Enumeration date
05/31/2005
Last updated
05/25/2024
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