Individual
SHANNON NICOLE BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR
Contact information
Practice address
8350 CRAIG ST, INDIANAPOLIS, IN 46250-3593
(317) 578-0410
Mailing address
8350 CRAIG ST, INDIANAPOLIS, IN 46250-3593
(317) 578-0410
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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