Individual
AMI BOUTERSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4235 GREEN BAY RD, KENOSHA, WI 53144-4516
(262) 652-1418
Mailing address
10319 81ST ST, PLEASANT PRAIRIE, WI 53158-2028
(262) 818-3563
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6206-154
WI
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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