Individual
TRACY BOUDREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
100 MARINERS PLAZA DR STE 11, MANDEVILLE, LA 70448-6805
(985) 231-9791
(985) 326-7452
Mailing address
27144 TAG A LONG RD, LACOMBE, LA 70445-4614
(985) 231-9791
(985) 326-7452
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z10954
LA
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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