Organization
BIANCA BOUCHER LCSW PLLC
Active
Other names
Sage Mind Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BIANCA BOUCHER LCSW-R (SOLE MEMBER)
(315) 767-0865
Entity
Organization
Contact information
Practice address
6006 NUMBER FOUR RD, LOWVILLE, NY 13367-3309
(315) 220-9525
Mailing address
6006 NUMBER FOUR RD, LOWVILLE, NY 13367-3309
(315) 220-9525
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/23/2024
Last updated
06/18/2024
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