Individual
JASON ANDREW BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 450-0585
(860) 450-0763
Mailing address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 450-0585
(860) 450-0763
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001475
CT
Other
Enumeration date
10/19/2007
Last updated
06/06/2014
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