Individual
LACEY M BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
4 MARKET PLACE DR # 15, YORK, ME 03909-1698
(207) 331-2381
Mailing address
2710 SANFORD RD, WELLS, ME 04090-6431
(207) 331-2381
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI1016
ME
Other
Enumeration date
08/31/2010
Last updated
02/06/2017
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