Organization
KIND BODY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISABELLE BOUCHARD MS, RD (PART OWNER)
(573) 615-4656
Entity
Organization
Contact information
Practice address
2012 CHERRY HILL DR STE 202B, COLUMBIA, MO 65203-5882
(573) 615-4656
Mailing address
2012 CHERRY HILL DR STE 202B, COLUMBIA, MO 65203-5882
(573) 615-4656
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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