Dr. Gerard E Boutin, Ph.D
Psychologist, Clinical in Largo, FL. Individual provider (NPI-1).
NPI number1083749386
StatusActive
Last updated in NPPESOct 15, 2019
Details
- NPI
- 1083749386
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gerard E Boutin
- Credential
- Ph.D
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 23, 2007
- Last updated
- Oct 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PY2716 | FL | Yes |
Practice location
13787 Belcher Rd S Ste 140Largo, FL 33771-4065
Phone 727-518-7394 · Fax 727-584-4937
Mailing address
13787 Belcher Rd S Ste 140Largo, FL 33771-4065
Phone 727-452-5083 · Fax 727-584-4937
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