Individual
MEGAN KRISTINE BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, OTR/L
Contact information
Practice address
4152 30TH AVE S STE 102, FARGO, ND 58104-8403
(701) 551-1751
Mailing address
701 3RD ST NW, JAMESTOWN, ND 58401-2963
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1655
ND
225XP0200X
Pediatric Occupational Therapist
Primary
1655
ND
Other
Enumeration date
06/11/2020
Last updated
03/06/2023
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