IndividualActive
Alisa Boucher, MS
NPI 1629740113 · Nutritionist · Waterford, MI
Provider details
- NPI number
- 1629740113
- Entity type
- Individual
- Primary specialty
- NutritionistDietary & Nutritional Service Providers
- Credential
- MS
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Dietary & Nutritional Service Providers
- Nutrition Education Nutritionist133NN1002X
Dietary & Nutritional Service Providers
Practice location
4233 Island Park Dr
Waterford, MI 48329-1916
Phone: (248) 468-6823
Approximate (ZIP-level) locationGet directions
Mailing address
7111 Dixie Hwy Ste 362
Clarkston, MI 48346-2077
Registry dates
- Enumerated
- 2021-10-02
- Last updated
- 2021-10-02
- Certified
- 2021-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.