Individual
KATHERINE BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 FAIRBANKS AVE, ALEXANDRIA, VA 22311-1246
(202) 779-2204
Mailing address
5000 FAIRBANKS AVE, ALEXANDRIA, VA 22311-1246
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008276
VA
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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