Jerry Paul Boudreaux L C S W

NPI 1366515702 - Social Worker - 1041C0700X

NPI Details
NPI 1366515702
Gender Male
Enumeration Date 11/15/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
549 E PASS RD
SUITE P
GULFPORT MS, 39507-3261, US
Phone (228) 896-9251
Fax (228) 897-6003
Business Location
549 E PASS RD
SUITE P
GULFPORT MS, 39507-3261, US
Phone (228) 896-9251
Fax (228) 897-6003
Toxanomy
Taxonomy Code 1041C0700X
License State Mississippi
License Number 0058
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According to our database, Mr. Jerry Paul Boudreaux L C S W NPI is 1366515702, taxonomy code is 1041C0700X and license number is 0058, license state is located at Mississippi. Jerry Paul Boudreaux L C S W physically located at 549 E Pass Rd, Gulfport MS, 39507-3261. NPI Number Jerry Paul Boudreaux L C S W has the Individual type.

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1366515702 NPI number is provided on an as is basis without warranty of any kind. 1366515702 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry Paul Boudreaux L C S W are for informational purposes only.