Individual
SAVANNAH KATHERINE BOULICAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
323 PAUL W BRYANT DR, TUSCALOOSA, AL 35401-2094
(314) 401-4955
Mailing address
1080 RIVERVIEW MANOR DR, FENTON, MO 63026-6141
(314) 401-4955
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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