Individual
DAWN BOUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26709 PATRICIA AVE, WARREN, MI 48091-4137
(586) 876-5739
Mailing address
26709 PATRICIA AVE, WARREN, MI 48091-4137
(586) 876-5739
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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