Provider Demographics
NPI:1376085894
Name:DESILVA, JEANETTE (MS)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:DESILVA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 THOMAS JONES WAY
Mailing Address - Street 2:800
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2580
Mailing Address - Country:US
Mailing Address - Phone:484-565-8200
Mailing Address - Fax:
Practice Address - Street 1:479 THOMAS JONES WAY
Practice Address - Street 2:800
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2580
Practice Address - Country:US
Practice Address - Phone:484-565-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)