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General NPI Number Information
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NPI Number | 1396841490
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Entity Type | Individual
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Provider Name | DARLENE S BOUDREAUX OTR
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Gender | Female
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 1811 W DEWITT HENRY DR
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City | BEEBE
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State | AR
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Zip | 72012-2026
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Country | US
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Telephone | 501-288-1199
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Fax | 501-882-3179
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Provider Business Mailing Address
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Address Line | 897 SHILOH RD
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City | BEEBE
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State | AR
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Zip | 72012-9897
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Country | US
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Telephone | 501-288-1199
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Fax | 501-882-3179
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR751
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License Number State | AR
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