MR. KYLE BOURQUE, LISW

Social Worker

Active Individual
NPI: 1124018650

Practice Address

USA MEDDAC ATTN: CREDENTIALS
11050 MT BELVEDERE BLVD
Fort Drum, NY 13602

Phone: (315) 772-4025

Specialties

Specialty Code Primary License
Social Worker 104100000X Yes 04825 (IA)

Frequently Asked Questions

NPI 1124018650 is the National Provider Identifier for MR. KYLE BOURQUE, LISW, a Social Worker provider located in Fort Drum, NY. This NPI was enumerated on October 26, 2005.
MR. KYLE BOURQUE, LISW practices at USA MEDDAC ATTN: CREDENTIALS, 11050 MT BELVEDERE BLVD, Fort Drum, NY 13602.

Quick Facts

NPI
1124018650
Type
Individual
Enumerated
Oct 26, 2005
Last Updated
Jan 24, 2022

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