Provider Demographics
NPI:1467716738
Name:DEYNES, DAISY L (MS SP ED)
Entity Type:Individual
Prefix:MS
First Name:DAISY
Middle Name:L
Last Name:DEYNES
Suffix:
Gender:F
Credentials:MS SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 LAKE OF THE PNES
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-7939
Mailing Address - Country:US
Mailing Address - Phone:570-588-3704
Mailing Address - Fax:570-588-3704
Practice Address - Street 1:1116 HOE AVE APT 5A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-2448
Practice Address - Country:US
Practice Address - Phone:570-588-3704
Practice Address - Fax:570-588-3704
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-01
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist