Individual
MELISSA BETH BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32411 BRIARCREST KNLS, FARMINGTON HILLS, MI 48334-1515
(917) 575-0823
Mailing address
32411 BRIARCREST KNLS, FARMINGTON HILLS, MI 48334-1515
(917) 575-0823
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
172V00000X
Community Health Worker
—
MI
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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