Individual
MARYANN BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3540 PUMP RD # 1136, RICHMOND, VA 23233-1115
(804) 455-8522
Mailing address
3540 PUMP RD # 1136, RICHMOND, VA 23233-1115
(804) 455-8522
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0004207
CO
103TC0700X
Clinical Psychologist
Primary
0810007450
VA
Other
Enumeration date
12/15/2006
Last updated
11/11/2024
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