Individual
MRS. ANNIE BOUCHEREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPTA
Contact information
Practice address
1 OAKWOOD BLVD STE 130, HOLLYWOOD, FL 33020-1937
(954) 925-3844
(954) 925-3845
Mailing address
1 OAKWOOD BLVD STE 130, HOLLYWOOD, FL 33020-1937
(954) 445-3064
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225100000X
Physical Therapist
Primary
PT19446
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
886421700
—
FL
Enumeration date
11/16/2006
Last updated
05/09/2025
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