Individual
DIANA BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
838 LAFAYETTE AVE APT 2, BROOKLYN, NY 11221-6863
(718) 360-7449
Mailing address
838 LAFAYETTE AVE APT 2, BROOKLYN, NY 11221-6863
(718) 360-7449
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
089932
NY
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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