Individual
CASSANDRA JENNA BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
451 E 83RD ST APT 6C, NEW YORK, NY 10028-6137
(516) 305-3092
Mailing address
451 E 83RD ST APT 6C, NEW YORK, NY 10028-6137
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
107136
NY
1041C0700X
Clinical Social Worker
Primary
095317
NY
Other
Enumeration date
01/02/2020
Last updated
12/14/2023
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