Provider Demographics
NPI:1104226083
Name:LAMOUR, CATHELINE BOURDEAU (MS)
Entity type:Individual
Prefix:
First Name:CATHELINE
Middle Name:BOURDEAU
Last Name:LAMOUR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CATHELINE
Other - Middle Name:BOURDEAU
Other - Last Name:LAMOUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:612 SE 31ST TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-3549
Mailing Address - Country:US
Mailing Address - Phone:239-243-0813
Mailing Address - Fax:
Practice Address - Street 1:2180 MARAVILLA LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7221
Practice Address - Country:US
Practice Address - Phone:239-332-8009
Practice Address - Fax:239-332-4977
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health