MEDICARE: MARYANN BOUCHER PSYD

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
1	103TC0700X	Clinical Psychologist	0004207	CO
2	103TC0700X	Clinical Psychologist	0810007450	VA

General Provider Information

NPI Number	:	1801958566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYANN BOUCHER PSYD

Provider Business Mailing Address
First Line	:	3540 PUMP RD # 1136
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-1115
Country	:	US
Telephone Number	:	804-455-8522
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 PUMP RD # 1136
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-1115
Country	:	US
Telephone Number	:	804-455-8522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	11/11/2024

Similar Medicare Providers

1992155592 — KATHERINE MAHAN LPC
Practice Location Address:

3540 PUMP RD # 1209
RICHMOND, VA
23233-1115

Practice Phone: 804-601-6190
Practice Fax:

1487160214 — MRS. ERIN SHANKS JONES BCBA
Practice Location Address:

3540 PUMP RD # 1039
RICHMOND, VA
23233-1115

Practice Phone: 248-846-8700
Practice Fax:

1215690623 — KATIE JO ROOD
Practice Location Address:

3540 PUMP RD
RICHMOND, VA
23233-1115

Practice Phone: 804-404-6270
Practice Fax: 804-294-2775

1134868128 — MR. CALVIN BARTELLE JR. LCSW
Practice Location Address:

3540 PUMP RD # 1030
RICHMOND, VA
23233-1115

Practice Phone: 404-594-1315
Practice Fax:

1982450482 — EMILEE BECK
Practice Location Address:

3540 PUMP RD STE 1188
RICHMOND, VA
23233-1115

Practice Phone: 804-404-6270
Practice Fax: 804-294-2775

1780701672 — DR. JONATHAN KLINEMAN D.D.S
Practice Location Address:

27127 CHARDON RD
RICHMOND HTS, OH
44143-1115

Practice Phone: 440-943-1117
Practice Fax: 440-943-9513

Directions to “ MARYANN BOUCHER PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.