Individual
MS. MELISSA NICOLE BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
105 CONVENTION DR, CARY, NC 27511-4595
(919) 234-0440
Mailing address
112 COACHMANS WHIP, BALDWINSVILLE, NY 13027-9600
(315) 391-1809
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
019085
NY
225X00000X
Occupational Therapist
11456
NC
Other
Enumeration date
11/04/2014
Last updated
11/21/2017
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