Provider Demographics
NPI:1689366908
Name:DN BOUCHARD
Entity type:Organization
Organization Name:DN BOUCHARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOUCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-670-5124
Mailing Address - Street 1:8918 TESORO DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6219
Mailing Address - Country:US
Mailing Address - Phone:210-670-5124
Mailing Address - Fax:210-319-5813
Practice Address - Street 1:8918 TESORO DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6219
Practice Address - Country:US
Practice Address - Phone:210-670-5124
Practice Address - Fax:210-319-5813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty