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Individual
TERESA ANN BOUCHARD
Active
Individual
TERESA ANN BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X002932-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0079064
GHI
NY
01
—
0878669
AETNA
NY
01
—
6687175
CIGNA
NY
01
—
X4495
BLUECROSS/BLUESHIELD
NY
Enumeration date
06/29/2006
Last updated
07/08/2007
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