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Individual

WANDA RAMONA BOUTTE

Active
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Individual

WANDA RAMONA BOUTTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
222Q00000X
Developmental Therapist
293646
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1376980227
ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES
CA
01
CA206171
NORIDIAN MEDICARE
CA
Enumeration date
06/02/2013
Last updated
11/22/2024
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