NPI 1063839454

Jason David Boucher, LPN

Practitioner Adult Companion Woonsocket, RI

Practice location

Address: 1625 Diamond Hill Rd, Woonsocket, RI 02895-1771
Phone: (401) 762-1511

Registered specialties

Adult Companion Primary

Nursing Service Related Providers Taxonomy 372600000X Licence 10720 (RI)

Other Adult Companion providers in Rhode Island →

Registry record

NPI: 1063839454
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Mar 2014
Record last updated: 24 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.