Individual
DR. JEANETTE FOX BOUROULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
217 E MAIN ST, ROCKAWAY, NJ 07866-3602
(973) 983-3919
Mailing address
5 KING HILL CT, DENVILLE, NJ 07834-3409
(860) 916-5135
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00711500
NJ
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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