Provider Demographics
NPI:1114701547
Name:VAUDREUIL, LOUVENA
Entity Type:Individual
Prefix:
First Name:LOUVENA
Middle Name:
Last Name:VAUDREUIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3343 HURRICANE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33462-3629
Mailing Address - Country:US
Mailing Address - Phone:561-577-3073
Mailing Address - Fax:
Practice Address - Street 1:3343 HURRICANE DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33462-3629
Practice Address - Country:US
Practice Address - Phone:561-577-3073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services