Bridgette Boucher, LCSW, MS
Social Worker, Clinical in New York, NY. Individual provider (NPI-1).
NPI number1164092961
StatusActive
Last updated in NPPESJun 25, 2021
Details
- NPI
- 1164092961
- Entity type
- Individual (NPI-1)
- Name
- Bridgette Boucher
- Credential
- LCSW, MS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 25, 2021
- Certification date
- Jun 25, 2021
- Last updated
- Jun 25, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 082710-01 | NY | Yes |
Practice location
2021 1st Ave Apt 4fNew York, NY 10029-5091
Phone 212-729-4549
Mailing address
2021 1st Ave Apt 4fNew York, NY 10029-5091
Phone 212-729-4549
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