Individual
MS. DAIL MARIE BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC-1, CADAC
Contact information
Practice address
111 EDGARTOWN VINEYARD HAVEN RD, VINEYARD HAVEN, MA 02568-4036
(508) 693-7900
(508) 696-0401
Mailing address
111 EDGARTOWN VINEYARD HAVEN RD, VINEYARD HAVEN, MA 02568-4036
(508) 693-7900
(508) 696-0401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
477
MA
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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