Individual
MARY BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
303 HICKORY ST, THIBODAUX, LA 70301-2011
(985) 447-0851
(985) 447-0971
Mailing address
303 HICKORY ST, THIBODAUX, LA 70301-2011
(985) 447-0851
(985) 447-0971
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
715
LA
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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