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Individual
MR. SAMUEL LAWRENCE BOUTIN
Active
Individual
MR. SAMUEL LAWRENCE BOUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
04/11/2013
Last updated
07/31/2014
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