Individual
MARY BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
504 FOUNTAINBLEU BLVD, ANDERSON, SC 29625-5808
(864) 376-0682
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/29/2023
Last updated
07/03/2023
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