Most Relevant Information
Provider Data
| NPI Number: | 1003692005 |
| Provider Name: | DESIREE DEVILLE LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 30374 |
Most Important Dates
| Enumeration Date: | 09/05/2023 |
| Last Updated: | 09/05/2023 |
Provider Practice Location
531 MAIN ST
LAUREL
MD
207074126
Practice Location Phone/Fax
| Phone: | 2404512171 |
| Fax: |
Provider Mailing Location
10125 PRINCE PL APT 304
UPPER MARLBORO
MD
207741127
Provider Mailing Phone/Fax
| Phone: | 2028675175 |
| Fax: |