Individual
MS. RACHEL M BOURGAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2186 HIGHWAY 14, BANNER, WY 82832-9709
(307) 737-2274
Mailing address
2186 HIGHWAY 14, BANNER, WY 82832-9709
(307) 737-2274
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
103
WY
Other
Enumeration date
03/20/2008
Last updated
03/20/2008
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