Individual
MS. ROSE BOUTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
681 CLARKSON AVE, BROOKLYN, NY 11203-2125
(718) 221-7421
Mailing address
248 42ND ST, COPIAGUE, NY 11726-1110
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
5552291
NY
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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