Provider Demographics
NPI:1740175942
Name:BOUCHARD, JOSEPHINE ESTO
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:ESTO
Last Name:BOUCHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CURTIS LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04461-3325
Mailing Address - Country:US
Mailing Address - Phone:207-852-8976
Mailing Address - Fax:
Practice Address - Street 1:48 CURTIS LN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:ME
Practice Address - Zip Code:04461-3325
Practice Address - Country:US
Practice Address - Phone:207-852-8976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPCA994253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care