Individual
MS. KATHLEEN M BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW MSW
Contact information
Practice address
1078 WEST MAIN ST, WATERBURY, CT 06708-2651
(203) 753-8336
(203) 753-7618
Mailing address
1078 WEST MAIN ST, WATERBURY, CT 06708-2651
(203) 753-8336
(203) 753-7618
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000296LCSW
CT
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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