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General NPI Number Information
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NPI Number | 1023381167
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Entity Type | Individual
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Provider Name | LISA A BOUDREAUX CPC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2012
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 1001 W PINHOOK RD BLDG. 3, STE. 226
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City | LAFAYETTE
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State | LA
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Zip | 70503-2448
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Country | US
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Telephone | 337-534-4789
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Fax | 337-534-4789
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Provider Business Mailing Address
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Address Line | 1001 W PINHOOK RD BLDG. 3, STE. 226
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City | LAFAYETTE
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State | LA
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Zip | 70503-2448
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Country | US
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Telephone | 337-534-4789
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Fax | 337-534-4789
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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