Melissa Bouchard
Peer Specialist in San Diego, CA. Individual provider (NPI-1).
NPI number1083173629
StatusActive
Last updated in NPPESMar 13, 2019
Details
- NPI
- 1083173629
- Entity type
- Individual (NPI-1)
- Name
- Melissa Bouchard
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2019
- Last updated
- Mar 13, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | CA | Yes |
Practice location
4104 Delta StSan Diego, CA 92113-4113
Phone 619-264-0141
Mailing address
4104 Delta StSan Diego, CA 92113-4113
Phone 619-264-0141
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