Individual
DONNA JEAN BOULAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44 MARITIME DR, MYSTIC, CT 06355-1958
(401) 829-6104
Mailing address
44 MARITIME DR, MYSTIC, CT 06355-1958
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
—
—
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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