Individual
JODIE ELIZABETH BOUMENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 HASWELL ST APT B, WESTERLY, RI 02891-1911
(631) 506-9686
Mailing address
15 HASWELL ST APT B, WESTERLY, RI 02891-1911
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00620-P
RI
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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