Individual
CHERYL BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
32 WINTHROP ST, AUGUSTA, ME 04330-5624
(207) 626-3448
(207) 621-6228
Mailing address
32 WINTHROP ST, AUGUSTA, ME 04330-5624
(207) 626-3448
(207) 621-6228
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435681499
—
ME
Enumeration date
06/10/2010
Last updated
06/10/2010
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