| NPI | 1063950285 |
|---|---|
| Former Name | LISA ANNE BOUDREAUX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP09186) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |