Provider Demographics
NPI:1417244096
Name:BOYER, RENEE MARIE (ATR)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:MARIE
Last Name:BOYER
Suffix:
Gender:F
Credentials:ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 JACKSON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5858
Mailing Address - Country:US
Mailing Address - Phone:504-581-3933
Mailing Address - Fax:504-596-3933
Practice Address - Street 1:1539 JACKSON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5858
Practice Address - Country:US
Practice Address - Phone:504-581-3933
Practice Address - Fax:504-596-3933
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA99-189221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist