Individual
DR. JENNIFER JEAN BODART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(570) 230-6864
Mailing address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(571) 230-6864
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
2443-57
WI
103TH0100X
Health Service Psychologist
Primary
2443-53
WI
Other
Enumeration date
10/16/2006
Last updated
05/01/2024
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