Individual
MARCIE BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED., C.A.S.
Contact information
Practice address
24A EAST STREET, RUTLAND, VT 05701
(518) 892-1184
Mailing address
24A EAST STREET, RUTLAND, VT 05701
(518) 892-1184
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1842527
NY
252Y00000X
Early Intervention Provider Agency
798464
NY
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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