Individual
MS. JUDY ELAINE BOUTON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
10 6TH ST, #214, ASTORIA, OR 97103
(503) 325-1598
Mailing address
10 6TH ST, #214, ASTORIA, OR 97103
(503) 325-1598
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
L1335
OR
Other
Enumeration date
05/19/2006
Last updated
07/08/2007
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