Individual
MS. REBECCA BOUCARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 S NEW BALLAS RD DEPT OF, SAINT LOUIS, MO 63141-8221
(636) 386-9224
(636) 386-7679
Mailing address
57 EXECUTIVE PARK SOUTH SUITE 300, ATLANTA, GA 30329
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2023049874
MO
Other
Enumeration date
01/09/2022
Last updated
01/15/2024
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