Doctor Name: | MRS. BERNANIE MARIE DESVARIEUX |
NPI Number: | 1194091207 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | |
Business Practice Address: | 1587 Decatur St North Baldwin, NY - 115102115 |
Business Phone Number: | 5166328395 |
Business Fax Number: | 5166328395 |
Mailing Address: | 1587 Decatur St, NORTH BALDWIN |
State: | NY |
Postal Code: | 115102115 |
Phone Number: | 5166328395 |
Fax Number: | 5166328395 |
NPI Enumeration Date: | 03/23/2012 |
NPI Last Update Date: | 03/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |