Healthcare Provider Details

I. General information

NPI: 1275714487
Provider Name (Legal Business Name): APRIL A DESMARAIS BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 TIBBETTS RD
FREMONT NH
03044-3573
US

IV. Provider business mailing address

12 TIBBETTS RD
FREMONT NH
03044-3573
US

V. Phone/Fax

Practice location:
  • Phone: 978-590-3084
  • Fax:
Mailing address:
  • Phone: 978-590-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: