Individual
MRS. KELLY ANN BOULIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9000 MOOSE RIVER ROAD, FORESTPORT, NY 13338
(315) 369-3269
Mailing address
PO BOX 396, OLD FORGE, NY 13420-0396
(315) 369-3269
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
483271-1
NY
Other
Enumeration date
11/14/2007
Last updated
11/14/2007
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