Individual
ANDREA NICOLE BOUVIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
225 E LEMON ST STE 105, LAKELAND, FL 33801-4632
(239) 690-6906
Mailing address
605 PIERMONT DR, DAVENPORT, FL 33897-5930
(321) 961-9683
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH23579
FL
Other
Enumeration date
04/08/2024
Last updated
06/19/2024
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