Provider Demographics
NPI:1881414977
Name:DE CARRIERE, DELAINIE MARIE
Entity type:Individual
Prefix:
First Name:DELAINIE
Middle Name:MARIE
Last Name:DE CARRIERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 S SPENCER
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-2634
Mailing Address - Country:US
Mailing Address - Phone:480-790-2691
Mailing Address - Fax:
Practice Address - Street 1:2044 N RECKER RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-2744
Practice Address - Country:US
Practice Address - Phone:623-745-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician