Doctor Name: | MS. JILLIAN DESIDERIO |
NPI Number: | 1154471233 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 069449-1 |
Business Practice Address: | 2000 Maple Hill St Suite 105 Yorktown Heights, NY - 105984176 |
Business Phone Number: | 9149625593 |
Business Fax Number: | 9149625599 |
Mailing Address: | 2000 Maple Hill St, Suite 105 YORKTOWN HEIGHTS |
State: | NY |
Postal Code: | 105984176 |
Phone Number: | 9149625593 |
Fax Number: | 9149625599 |
NPI Enumeration Date: | 01/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 069449-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |