Jennica Phenide Bouquet
Psychiatry & Neurology, Child & Adolescent Psychiatry in Atlanta, GA. Individual provider (NPI-1).
NPI number1962039719
StatusActive
Last updated in NPPESOct 19, 2026
Details
- NPI
- 1962039719
- Entity type
- Individual (NPI-1)
- Name
- Jennica Phenide Bouquet
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 23, 2020
- Certification date
- Oct 19, 2026
- Last updated
- Oct 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology, Child & Adolescent Psychiatry | 114256 | GA | Yes |
Practice location
1920 Briarcliff Rd NeAtlanta, GA 30329-4010
Phone 404-785-8328
Mailing address
1920 Briarcliff Rd NeAtlanta, GA 30329-4010
Phone 404-785-8328
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