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Individual

ALISHA HELEN KHOURY-BOUCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED, LADC I, CADC

Contact information

Practice address
21 KINGSLEY ST, SPRINGFIELD, MA 01104-2711
(413) 530-0741
Mailing address
21 KINGSLEY ST, SPRINGFIELD, MA 01104-2711
(413) 530-0741

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
12/30/2020
Last updated
12/30/2020
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