Individual
ALIXANDRA BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 MARKET ST, PHILADELPHIA, PA 19139-4636
(215) 590-7555
Mailing address
4601 MARKET ST, PHILADELPHIA, PA 19139-4636
(617) 794-5567
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH11666
MA
101YP2500X
Professional Counselor
Primary
PC015305
PA
Other
Enumeration date
11/30/2022
Last updated
05/09/2023
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