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NPI Code Detail

MEDICARE: CHANICE UNCHELLE BOUDREAUX LMT

MEDICARE: CHANICE UNCHELLE BOUDREAUX LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistLA9008LA

General Provider Information

NPI Number : 1760019913
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANICE UNCHELLE BOUDREAUX LMT
Provider Business Mailing Address
First Line : 3320 WARREN DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70814-4056
Country : US
Telephone Number : 225-428-6614
Fax Number : 225-217-0237
Provider Business Practice Location Address
First Line : 3103 MONTERREY DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70814-4024
Country : US
Telephone Number : 225-428-6614
Fax Number : 225-217-0237
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2020
Last Update Date : 10/27/2025

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Directions to “ CHANICE UNCHELLE BOUDREAUX LMT” Practice Location

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