Provider Demographics
NPI:1841065489
Name:BOUCKE, APRIL (MT-BC)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:BOUCKE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 PONTIAC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2537
Mailing Address - Country:US
Mailing Address - Phone:586-419-2169
Mailing Address - Fax:
Practice Address - Street 1:1669 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-1230
Practice Address - Country:US
Practice Address - Phone:248-646-3347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist