Individual
THERESA SHERYL BOUGOUNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, LADC 1
Contact information
Practice address
31 JOHN ST # 2, ATTLEBORO, MA 02703-2027
(781) 414-0099
Mailing address
31 JOHN ST # 2, ATTLEBORO, MA 02703-2027
(781) 414-0099
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21620
MA
101YM0800X
Mental Health Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2012
Last updated
09/02/2024
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