Basic Information
| Provider Information | |||||||||
| NPI: | 1447422902 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | BOUDREAUX | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 WICHERS DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MARRERO | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700723023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043498833 | ||||||||
| FaxNumber: | 5043498844 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 W ESPLANADE AVE S | ||||||||
| Address2: | SUITE 213 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700027406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048385716 | ||||||||
| FaxNumber: | 5048385714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2008 | ||||||||
| LastUpdateDate: | 03/25/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.