Individual
DAVE ROCH BOUCHARD
Active
Individual
DAVE ROCH BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
575
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1405991Y0NH01
ANTHEM
NH
01
—
889985A
MVP HEALTHCARE
NH
01
—
H002311
CHAMPUS
NH
Enumeration date
12/27/2006
Last updated
07/08/2007
Update your record
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