Individual
MRS. MICHELE A BOUTILIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LHIS
Contact information
Practice address
2400 N. CROATOAN HWY, SUITE G, KILL DEVIL HILLS, NC 27948
(252) 441-2595
(252) 441-2595
Mailing address
128 ACORN LANE, POINT HARBOR, NC 27964
(252) 441-2595
(252) 441-2595
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1003
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003
NC HEARING AID LICENSE BO
NC
Enumeration date
09/21/2007
Last updated
02/25/2015
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