Provider Demographics
NPI:1679767347
Name:DEFORREST OUJAIMI, DENISE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:M
Last Name:DEFORREST OUJAIMI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:DEFORREST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:54 BUSH HILL RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-3000
Mailing Address - Country:US
Mailing Address - Phone:978-452-9229
Mailing Address - Fax:978-452-3752
Practice Address - Street 1:25 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1905
Practice Address - Country:US
Practice Address - Phone:978-452-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2028845101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health