Doctor Name: | MARILYN CARTER-BOUCHER |
NPI Number: | 1205124161 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CAC3892 |
License Number: | CAC3892 |
Business Practice Address: | 1 Delta Dr Westbrook, ME - 040924745 |
Business Phone Number: | 2078567227 |
Business Fax Number: | 2078562112 |
Mailing Address: | 1 Delta Dr, WESTBROOK |
State: | ME |
Postal Code: | 040924745 |
Phone Number: | 2078567227 |
Fax Number: | 2078562112 |
NPI Enumeration Date: | 07/13/2011 |
NPI Last Update Date: | 07/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CAC3892 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |