Individual
MILANGE DERISTILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
2640 FOREST HILL BLVD, WEST PALM BEACH, FL 33406-5931
(561) 616-8411
Mailing address
1021 19TH ST, WEST PALM BEACH, FL 33407-5710
(203) 802-0877
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/22/2013
Last updated
12/07/2018
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