Individual
ELLEN BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7169 EDINBOROUGH, WEST BLOOMFIELD, MI 48322-4027
(248) 752-3314
(248) 855-1019
Mailing address
7169 EDINBOROUGH, WEST BLOOMFIELD, MI 48322-4027
(248) 752-3314
(248) 855-1019
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004040
MI
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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