Individual
KELLY BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
2 MORNINGDALE AVE, BOYLSTON, MA 01505-1915
(508) 873-9813
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9721
MA
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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