Individual
MRS. GINA ELIZABETH BOUCHETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-6002
Mailing address
217 HIGH ST RURAL, LEBANON, PA 17042-9026
(724) 840-2046
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003543
PA
Other
Enumeration date
07/22/2006
Last updated
07/08/2007
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