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Individual

GABRIEL Y EL-HAGE BOUTROUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
4565 DRESSLER RD NW, SUITE LL 21, CANTON, OH 44718-2549
(330) 491-9700
(330) 491-9730
Mailing address
4565 DRESSLER RD NW, SUITE LL 21, CANTON, OH 44718-2549
(330) 491-9700
(330) 491-9730

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3718
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0685290
OH
Enumeration date
04/21/2006
Last updated
11/02/2007
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