MISS Mary Bourque, MOT, LOTR

NPI #1326403445 in Carencro, Louisiana

Provider Information

NPI Number: 1326403445
Entity Type: Individual
Name: MISS Mary Bourque, MOT, LOTR
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: MOT, LOTR
Enumeration Date: Dec 16, 2015
Last Updated: Oct 5, 2017

Practice Location

Address: 204 E SAINT PETER ST
City: Carencro
State: Louisiana
ZIP Code: 70520-4009
Phone: (337) 896-6686

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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