Trisha Boucher

Individual provider Active NPI Developmental Therapist · Arundel, ME

NPI 1184820136 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1184820136
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
License
0252201 (ME)
Practice address
39 Limerick Rd
Arundel, ME 04046-8158
Phone
(207) 985-7861
Fax
(207) 985-6703
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0252201MEMDDevelopmental Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 0252201 ME Yes

Addresses

Primary practice location

39 Limerick Rd
Arundel, ME 04046-8158

Mailing address

39 Limerick Rd
Arundel, ME 04046-8158
Phone (207) 985-7861

Other providers in Arundel, ME

All providers in Arundel, ME · Developmental Therapist in Maine

Sources for this page

Verify at the official NPI Registry.