Individual
INDIANNA MCKENNA BOUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21101 DALE EVANS PKWY, APPLE VALLEY, CA 92307-9356
(909) 387-5874
Mailing address
1950 S SUNWEST LN STE 200, SAN BERNARDINO, CA 92408-3248
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/01/2022
Last updated
08/28/2025
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