Provider Demographics
NPI:1801139258
Name:DESA@ASSOCIATES
Entity type:Organization
Organization Name:DESA@ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:DESA
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,PMH-NP,BC
Authorized Official - Phone:978-692-0096
Mailing Address - Street 1:319 LITTLETON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-4126
Mailing Address - Country:US
Mailing Address - Phone:978-692-0096
Mailing Address - Fax:
Practice Address - Street 1:319 LITTLETON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-4126
Practice Address - Country:US
Practice Address - Phone:978-692-0096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234922163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty