Individual
MRS. JOELLE MARIE BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW-C
Contact information
Practice address
9 HILLCREST AVE, RANDOLPH, ME 04346-5131
(207) 615-6261
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1200
(207) 871-1232
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSX13484
ME
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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