Individual
MR. JEREMY B BOULIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-CC
Contact information
Practice address
647 MAIN ST STE 14B, CARIBOU, ME 04736-4509
(207) 492-3009
(207) 492-0034
Mailing address
647 MAIN ST STE 14B, CARIBOU, ME 04736-4509
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC17679
ME
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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