Individual
MICHELLE DENISE BOUCHER-SNODGRASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2449 N PARK DR STE C, MERIDIAN, MS 39305-2669
(601) 282-5250
(601) 286-5305
Mailing address
2449 N PARK DR STE C, MERIDIAN, MS 39305-2669
(601) 282-5250
(601) 286-5305
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
45-732
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07170249
—
MS
Enumeration date
08/14/2006
Last updated
07/29/2024
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