DANIEL JOHN BOUCHARD

VENICE, CA
NPI1457901589
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2019-09-20
Last Update Date2019-09-20
Business Address
DANIEL JOHN BOUCHARD RADT
503 OCEAN FRONT WALK
VENICE, CA 90291-2403
Phone number: 310-392-4925
Mailing Address
DANIEL JOHN BOUCHARD RADT
503 OCEAN FRONT WALK
VENICE, CA 90291-2403
Phone number: 310-392-4925
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