Provider Demographics
NPI:1073387981
Name:BOUHOUT, JENY (IBCLC)
Entity Type:Individual
Prefix:
First Name:JENY
Middle Name:
Last Name:BOUHOUT
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 SW INDIAN KEY DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2076
Mailing Address - Country:US
Mailing Address - Phone:305-600-6037
Mailing Address - Fax:
Practice Address - Street 1:631 SW INDIAN KEY DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2076
Practice Address - Country:US
Practice Address - Phone:305-600-6037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN