Individual
MR. JEREMY PAUL BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
615 N SHERMAN AVE STE 24, MADISON, WI 53704-4457
(608) 445-2510
(262) 293-9777
Mailing address
615 N SHERMAN AVE STE 24, MADISON, WI 53704-4457
(608) 445-2510
(262) 293-9777
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10072-123
WI
1041C0700X
Clinical Social Worker
149020671
IL
1041C0700X
Clinical Social Worker
22128
WI
Other
Enumeration date
04/01/2019
Last updated
04/23/2024
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