Provider Demographics
NPI:1508362641
Name:STROTHER-BOUDREAUX, LLC
Entity Type:Organization
Organization Name:STROTHER-BOUDREAUX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:STROTHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:337-534-4214
Mailing Address - Street 1:1602 W PINHOOK RD STE 303
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3735
Mailing Address - Country:US
Mailing Address - Phone:337-534-4214
Mailing Address - Fax:337-484-1405
Practice Address - Street 1:1602 W PINHOOK RD STE 303
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3735
Practice Address - Country:US
Practice Address - Phone:337-534-4214
Practice Address - Fax:337-484-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health