Provider Demographics
NPI:1962147538
Name:BOUCHER, ALLYSON LEE (PA)
Entity type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:LEE
Last Name:BOUCHER
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Gender:F
Credentials:PA
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Mailing Address - Street 1:238 NORTHAMPTON ST
Mailing Address - Street 2:EASTHAMPTON HEALTH CENTER
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027
Mailing Address - Country:US
Mailing Address - Phone:413-529-9300
Mailing Address - Fax:866-644-0870
Practice Address - Street 1:238 NORTHAMPTON ST
Practice Address - Street 2:EASTHAMPTON HEALTH CENTER
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027
Practice Address - Country:US
Practice Address - Phone:413-529-9300
Practice Address - Fax:866-644-0870
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2023-03-30
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Provider Licenses
StateLicense IDTaxonomies
MAPA8730363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant