Individual
JEAN LOUISE BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC,MS
Contact information
Practice address
165 FIR LN, VIDOR, TX 77662-9206
(903) 920-3964
Mailing address
165 FIR LN, VIDOR, TX 77662-9206
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14001
TX
Other
Enumeration date
05/22/2026
Last updated
05/22/2026
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