Individual
JORDAN LYNN BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
110 LIBERTY ST STE 2A, BROCKTON, MA 02301-5674
(508) 894-0766
(508) 565-0097
Mailing address
110 LIBERTY ST, BROCKTON, MA 02301-5674
(508) 894-0400
(508) 894-0628
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI 60543717
WA
Other
Enumeration date
07/02/2015
Last updated
05/04/2020
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