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1386925683
MARK DECLOUET
LAFAYETTE, LA
NPI
1386925683
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA ap08202)
Enumeration Date
2011-08-31
Last Update Date
2020-12-29
Business Address
Mr. MARK DECLOUET NP
315 AUDUBON BLVD
LAFAYETTE, LA 70503-2610
Phone number: 337-522-7573
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Mailing Address
Mr. MARK DECLOUET NP
PO BOX 53709
LAFAYETTE, LA 70505-3709
Phone number: 877-294-7247
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