Individual
AUDREY BOUTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
621 S CULLEN AVE, SUITE 118, EVANSVILLE, IN 47715-4137
(812) 491-9400
Mailing address
796 S RUSTIC LN, JASPER, IN 47546-9355
(812) 309-9795
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
10373
IN
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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