Individual
MRS. CHENIQUE L BOUTELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
107 WINNIE ST, ALBANY, NY 12208-2051
(518) 487-9950
Mailing address
107 WINNIE ST, ALBANY, NY 12208-2051
(518) 487-9950
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
093791
NY
Other
Enumeration date
10/24/2018
Last updated
02/21/2024
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