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1407152234
CERISE ELISE BOUCHARD
LEXINGTON, KY
NPI
1407152234
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
(Licence: KY 201197964)
Enumeration Date
2011-01-26
Last Update Date
2022-06-14
Business Address
CERISE ELISE BOUCHARD CLC
1733 BROOK PARK DR
LEXINGTON, KY 40515-1306
Phone number: 859-576-1062
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Mailing Address
CERISE ELISE BOUCHARD CLC
1733 BROOK PARK DR
LEXINGTON, KY 40515-1306
Phone number: 859-576-1062
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