Individual
AUDREY BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
34 CRESCENT ST, WILMINGTON, MA 01887-1957
(617) 306-3721
Mailing address
34 CRESCENT ST, WILMINGTON, MA 01887-1957
(617) 306-3721
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
118372
MA
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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