Provider Demographics
NPI:1982976627
Name:BOUCHARD, DANIELLE N (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:N
Last Name:BOUCHARD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8353 WINDWAY DR
Mailing Address - Street 2:
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78239-2438
Mailing Address - Country:US
Mailing Address - Phone:210-670-5124
Mailing Address - Fax:210-319-5813
Practice Address - Street 1:8353 WINDWAY DR
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-2438
Practice Address - Country:US
Practice Address - Phone:210-670-5124
Practice Address - Fax:210-319-5813
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68608101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor