| Doctor Name: | JENNIFER L. DESJARDINS |
| NPI Number: | 1215123682 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MHRT-C |
| License Number: | LC5168 |
| Business Practice Address: | 31 Market St Fort Kent, ME - 047431418 |
| Business Phone Number: | 2074367027 |
| Business Fax Number: | |
| Mailing Address: | 175 Strip Rd, Po Box 314 FORT KENT |
| State: | ME |
| Postal Code: | 047431552 |
| Phone Number: | 2074367027 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2007 |
| NPI Last Update Date: | 11/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LC5168 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |