Individual
DR. MICHAEL LOUIS BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
307 SEMLOH DR, SYRACUSE, NY 13219-2829
(315) 468-0558
Mailing address
307 SEMLOH DR, SYRACUSE, NY 13219-2829
(315) 468-0558
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
003804
NY
Other
Enumeration date
04/23/2007
Last updated
09/07/2016
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