Provider Demographics
NPI:1477781276
Name:JOUBERT, ANNETTE MARIE (JOUBERT ANNETTE)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARIE
Last Name:JOUBERT
Suffix:
Gender:F
Credentials:JOUBERT ANNETTE
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:MARIE
Other - Last Name:JOUBERT-MOWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JOUBERT ANNETTE NCMT
Mailing Address - Street 1:11 OAK GLEN PL
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-2028
Mailing Address - Country:US
Mailing Address - Phone:201-213-2856
Mailing Address - Fax:973-428-9431
Practice Address - Street 1:11 OAK GLEN PL
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-2028
Practice Address - Country:US
Practice Address - Phone:201-213-2856
Practice Address - Fax:973-428-9431
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00012600171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor