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NPI Code Detail

MEDICARE: KATHERINE E. BOUCHA LMSW

MEDICARE: KATHERINE E. BOUCHA LMSW
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
11041C0700XClinical Social Worker6801087752MI

General Provider Information

NPI Number : 1871695502
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE E. BOUCHA LMSW
Provider Business Mailing Address
First Line : 1402 S SAGINAW ST
Second Line :
City : FLINT
State : MI
Zip : 48503-3705
Country : US
Telephone Number : 810-257-3777
Fax Number : 810-496-5776
Provider Business Practice Location Address
First Line : 1402 S SAGINAW ST
Second Line :
City : FLINT
State : MI
Zip : 48503-3705
Country : US
Telephone Number : 810-257-3777
Fax Number : 810-496-5776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 03/19/2024

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Directions to “ KATHERINE E. BOUCHA LMSW” Practice Location

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