Ethan Emery Bourque
Ethan Emery Bourque is a Counselor in Wilton, Connecticut. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
396 Danbury Rd Ste 2AWilton, CT 06897-2024
Phone: (203) 202-7654
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|
Record details
| NPI number | 1376321000 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | September 14, 2023 |
| Last updated in NPPES | September 14, 2023 |
| Certification date | September 14, 2023 |
| Mailing address | 396 Danbury Rd Ste 2a, Wilton, CT 06897-2024 |
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