Individual
MRS. JOANN BOURET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5520 VAN CLEEF ST, 2, CORONA, NY 11368-3908
(917) 224-4115
Mailing address
5520 VAN CLEEF ST, 2, CORONA, NY 11368-3908
(917) 224-4115
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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