Individual
JEFFREY LOBERIANO BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
59 DAVIS ST, OLD TOWN, ME 04468-1337
(323) 898-9622
Mailing address
59 DAVIS ST, OLD TOWN, ME 04468-1337
(323) 898-9622
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95038702
CA
Other
Enumeration date
02/27/2026
Last updated
02/27/2026
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