Individual
AMANDA W BOULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7647 MUSTANG MDW, SAN ANTONIO, TX 78244-3531
(512) 618-7669
Mailing address
7647 MUSTANG MDW, SAN ANTONIO, TX 78244-3531
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
70623
TX
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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