Provider Demographics
NPI:1376177162
Name:DESAMOURS, DARLINE (SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:DARLINE
Middle Name:
Last Name:DESAMOURS
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5266
Mailing Address - Country:US
Mailing Address - Phone:609-271-0662
Mailing Address - Fax:609-568-6764
Practice Address - Street 1:45 W WEST JERSEY AVE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-2629
Practice Address - Country:US
Practice Address - Phone:609-271-0662
Practice Address - Fax:609-568-6764
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker