| Doctor Name: | PATRICIA DESJARLAIS |
| NPI Number: | 1962886812 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | F401840 |
| Business Practice Address: | 4 Fuller St Alexandria Bay, NY - 136071316 |
| Business Phone Number: | 3154821230 |
| Business Fax Number: | 3154825553 |
| Mailing Address: | 4 Fuller St, ALEXANDRIA BAY |
| State: | NY |
| Postal Code: | 136071316 |
| Phone Number: | 3154821230 |
| Fax Number: | 3154825553 |
| NPI Enumeration Date: | 07/09/2015 |
| NPI Last Update Date: | 02/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | F401840 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |