Individual
DANA BOUCHILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
810 GREENWOOD AVE, CLARKSVILLE, TN 37040-4068
(931) 206-8598
Mailing address
1517 BASTOGNE AVE # A, FORT CAMPBELL, KY 42223-3505
(931) 536-4897
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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