Provider Demographics
NPI:1205197555
Name:DEUS PIERRE, CHANTALE (MSW)
Entity Type:Individual
Prefix:
First Name:CHANTALE
Middle Name:
Last Name:DEUS PIERRE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 FOX TRAIL AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-5259
Mailing Address - Country:US
Mailing Address - Phone:352-459-4164
Mailing Address - Fax:
Practice Address - Street 1:1031 FOX TRAIL AVE
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-5259
Practice Address - Country:US
Practice Address - Phone:352-459-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker