Individual
NATASHA BOUCHILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 S BEECH ST STE B102, CORTEZ, CO 81321-3751
(970) 946-1539
(719) 638-8115
Mailing address
23 S BEECH ST STE B102, CORTEZ, CO 81321-3751
(970) 946-1539
(719) 638-8115
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-39392
CO
103K00000X
Behavior Analyst
7401001019
MI
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/09/2016
Last updated
08/10/2021
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