Fayne Bouguyon

NPI 1356051783 · on the registry since 2022 · sole proprietor

Practice

Address: 1719 Analog Dr
Richardson, TX 75081
Phone: (214) 476-1719
Organisation at this address: Simplyaware Llc
Viveri Youth Services Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 2255A2300X
2255A2300X
Also registered as: 171400000X
225700000X
225800000X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-01-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas