| Doctor Name: | MS. CAROLYN ELIZABETH BOUDREAUX |
| NPI Number: | 1558536342 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., CCC-SLP |
| License Number: | 5657 |
| Business Practice Address: | 2900 Charlevoix Dr Se Suite 200 Grand Rapids, MI - 495467085 |
| Business Phone Number: | 8003258064 |
| Business Fax Number: | 8003251326 |
| Mailing Address: | 1748 E Hermitage St, GONZALES |
| State: | LA |
| Postal Code: | 707374914 |
| Phone Number: | 2257153753 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2008 |
| NPI Last Update Date: | 04/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 5657 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |