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1710748488
MITCHELL ALLEN BOUSSON
MODESTO, CA
NPI
1710748488
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA 95273030)
Enumeration Date
2024-01-19
Last Update Date
2024-01-19
Business Address
Mr. MITCHELL ALLEN BOUSSON
500 N 9TH ST
MODESTO, CA 95350-5814
Phone number: 209-558-4598
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Mailing Address
Mr. MITCHELL ALLEN BOUSSON
900 N 9TH ST
MODESTO, CA 95350-4723
Phone number: 209-558-4598
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