Provider Demographics
NPI:1326485996
Name:BOUCHER, HILARY SUSAN (OTR)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:SUSAN
Last Name:BOUCHER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 POND VIEW CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2196
Mailing Address - Country:US
Mailing Address - Phone:615-794-0922
Mailing Address - Fax:
Practice Address - Street 1:409 POND VIEW CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2196
Practice Address - Country:US
Practice Address - Phone:615-794-0922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000186225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics