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Individual

RAYMOND ROGER BOUCHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
194 MISSILE AVENUE, MINOT AFB, ND 58705
(701) 723-5527
Mailing address
755 SCOTT CIR, JBPHH, HI 96853-5399
(808) 448-6377

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC5945
ME

Other

Enumeration date
09/24/2006
Last updated
11/26/2025
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