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Jerry Boudreaux, L C S W

NPI 1366515702 · on the registry since 2006

Practice

Address: 549 E Pass Rd
Suite P
Gulfport, MS 39507
Phone: (228) 896-9251
Fax: (228) 897-6003
Organisation at this address: Magnolia Mental Health And Wellness Pllc
Fairy Wings Mobile Phlebotomy Service Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: Clinical Social Worker
1041C0700X
Licence states on file: MS
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi