Individual
BIANCA J BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
6006 NUMBER FOUR RD, LOWVILLE, NY 13367-3309
(315) 220-9525
Mailing address
6006 NUMBER FOUR RD, LOWVILLE, NY 13367-3309
(315) 220-9525
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
079346
NY
1041C0700X
Clinical Social Worker
Primary
082689
NY
Other
Enumeration date
07/20/2011
Last updated
06/18/2024
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