Provider Demographics
NPI:1225386790
Name:DESIR, GUERLINE LILY (MA, MENTAL HEALTH)
Entity Type:Individual
Prefix:MS
First Name:GUERLINE
Middle Name:LILY
Last Name:DESIR
Suffix:
Gender:F
Credentials:MA, MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 ST MONTELENA CT
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-3805
Mailing Address - Country:US
Mailing Address - Phone:813-468-8837
Mailing Address - Fax:
Practice Address - Street 1:3097 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-4715
Practice Address - Country:US
Practice Address - Phone:813-606-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health