Provider Demographics
NPI:1689954299
Name:ARDUINI, DESIREE MICHELLE (MA)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:MICHELLE
Last Name:ARDUINI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900B RALPH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5302
Mailing Address - Country:US
Mailing Address - Phone:718-253-1366
Mailing Address - Fax:718-253-5890
Practice Address - Street 1:1900B RALPH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5302
Practice Address - Country:US
Practice Address - Phone:718-253-1366
Practice Address - Fax:718-253-5890
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist