Provider Demographics
NPI:1992147342
Name:BOUDOIN, YVETTE DENISE (ARDMS)
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:DENISE
Last Name:BOUDOIN
Suffix:
Gender:F
Credentials:ARDMS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1262 OAK HAVEN WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-8312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:478-274-5671
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA1337602471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography