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NPI Code Detail

MEDICARE: IRENE BOUCHARD

MEDICARE: IRENE BOUCHARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1710180013
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE BOUCHARD
Provider Business Mailing Address
First Line : 1019 E WATER ST
Second Line :
City : ELMIRA
State : NY
Zip : 14901-3332
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1019 E WATER ST
Second Line :
City : ELMIRA
State : NY
Zip : 14901-3332
Country : US
Telephone Number : 607-733-5696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2007
Last Update Date : 03/08/2026

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Directions to “ IRENE BOUCHARD ” Practice Location

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