| Doctor Name: | MRS. TERI BOUDREAU |
| NPI Number: | 1295746675 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | |
| Business Practice Address: | 21 Heritage Dr Ste 102 Bourbonnais, IL - 60914 |
| Business Phone Number: | 8159378204 |
| Business Fax Number: | 8159378798 |
| Mailing Address: | 9223 W St Francis Rd, FRANKFORT |
| State: | IL |
| Postal Code: | 60423 |
| Phone Number: | 8158063111 |
| Fax Number: | 8154642621 |
| NPI Enumeration Date: | 08/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |