Individual
MARIAN BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
23 HIGH ST, FORT FAIRFIELD, ME 04742-1021
(207) 768-4736
(207) 768-4738
Mailing address
23 HIGH ST, FORT FAIRFIELD, ME 04742-1021
(207) 768-4736
(207) 768-4738
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC9979
ME
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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