Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 1112175 | TX |
N | 2251N0400X | Physical Therapist - Neurology | 1112175 | TX |
N | 2251P0200X | Physical Therapist - Pediatrics | 1112175 | TX |
N | 225X00000X | Occupational Therapist | 108312 | TX |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 108312 | TX |
N | 225XP0200X | Occupational Therapist - Pediatrics | 108312 | TX |
NPI | 1447329255 |
---|---|
Provider Name | Dr. Barbara Henkel Boucher |
First Address | San Antonio, TX 78230-4410 |
Second Address | San Antonio, TX 78230-4410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 09/07/2007 |