Raven Boutte
Raven Boutte is a Clinical Pathology Physician in Lafayette, Louisiana. Practices as a sole proprietor. Licensed in Louisiana.
- Licensed in
- LA
- In the registry since
- 2021
Practice location Address checks out
4510 Ambassador Caffery PkwayLafayette, LA 70508
Phone: (337) 458-3835
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Pathology Physician (primary) | Taxonomy 207ZC0006X · Licence 1003007 (LA) |
|---|
Record details
| NPI number | 1982374187 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | September 18, 2021 |
| Last updated in NPPES | September 18, 2021 |
| Certification date | September 18, 2021 |
| Mailing address | 100 McDonald St Apt D17, Lafayette, LA 70506 |