Individual
PAIGE BOUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2825 HILLEGAS RD, FORT WAYNE, IN 46808-3859
(260) 338-1241
Mailing address
1690 S THAYER RD, LIMA, OH 45806-9277
(260) 449-0563
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/17/2019
Last updated
12/10/2021
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