Most Relevant Information
Provider Data
| NPI Number: | 1003308396 |
| Provider Name: | ELLEN BOUDREAUX CPSS, ITE |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/01/2018 |
| Last Updated: | 06/01/2018 |
Provider Practice Location
711 COLONIAL DR STE D
BATON ROUGE
LA
708066549
Practice Location Phone/Fax
| Phone: | 2252462162 |
| Fax: |
Provider Mailing Location
945 RIDGEPOINT CT
BATON ROUGE
LA
708102877
Provider Mailing Phone/Fax
| Phone: | 2256366161 |
| Fax: |