| NPI | 1053139089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HEBERT BOUDREAUX Owner 985-306-8676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |