MARK DECLOUET

LAFAYETTE, LA
NPI1386925683
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA  ap08202)
Enumeration Date2011-08-31
Last Update Date2020-12-29
Business Address
Mr. MARK DECLOUET NP
315 AUDUBON BLVD
LAFAYETTE, LA 70503-2610
Phone number: 337-522-7573
Mailing Address
Mr. MARK DECLOUET NP
PO BOX 53709
LAFAYETTE, LA 70505-3709
Phone number: 877-294-7247