Provider Demographics
NPI:1811269715
Name:DUCREPIN-JEROME, JOANNE
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DUCREPIN-JEROME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 GROVE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2833
Mailing Address - Country:US
Mailing Address - Phone:908-393-2725
Mailing Address - Fax:
Practice Address - Street 1:350 GROVE ST STE 206
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2833
Practice Address - Country:US
Practice Address - Phone:908-393-2725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health