Individual
MRS. LAUREN G BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
99 MULFORD RD., ANDOVER, NJ 07821
(973) 383-6200
Mailing address
44 VENETIAN DR, LAKE HOPATCONG, NJ 07849-2220
(201) 213-7209
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00201000
NJ
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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