Healthcare Provider Details

I. General information

NPI: 1417244096
Provider Name (Legal Business Name): RENEE MARIE BOYER ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 07/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1539 JACKSON AVE SUITE 300
NEW ORLEANS LA
70130-5858
US

IV. Provider business mailing address

1539 JACKSON AVE SUITE 300
NEW ORLEANS LA
70130-5858
US

V. Phone/Fax

Practice location:
  • Phone: 504-581-3933
  • Fax: 504-596-3933
Mailing address:
  • Phone: 504-581-3933
  • Fax: 504-596-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number99-189
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: