Provider Demographics
NPI:1578686465
Name:DENIS-DESTOUCHES, WILLHERMINE (BS)
Entity Type:Individual
Prefix:MRS
First Name:WILLHERMINE
Middle Name:
Last Name:DENIS-DESTOUCHES
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-2602
Mailing Address - Country:US
Mailing Address - Phone:781-665-3181
Mailing Address - Fax:781-665-3181
Practice Address - Street 1:22 CHURCH ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-2718
Practice Address - Country:US
Practice Address - Phone:781-306-4820
Practice Address - Fax:781-397-6554
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist