Individual
FAYNE A BOUGUYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1719 ANALOG DR, RICHARDSON, TX 75081-1944
(214) 476-1719
Mailing address
2606 CHINKAPIN LN, ROWLETT, TX 75089-1611
(214) 476-1719
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
2255A2300X
Athletic Trainer
Primary
—
—
225700000X
Massage Therapist
MT042244
TX
225800000X
Recreation Therapist
—
—
Other
Enumeration date
11/28/2022
Last updated
01/11/2023
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