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Individual

GABRIELA BOURQUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2626 CHARLES DR, CHALMETTE, LA 70043-3779
(504) 278-4006
Mailing address
186 MARTIN LN, DES ALLEMANDS, LA 70030-4127
(504) 858-6320

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/21/2014
Last updated
03/21/2014
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