Individual
DIANE C DESMARAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LADC
Contact information
Practice address
141 E MAIN ST, WATERBURY, CT 06702-2310
(203) 575-0466
(203) 575-1817
Mailing address
141 E MAIN ST, WATERBURY, CT 06702-2310
(203) 575-0466
(203) 575-1817
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000822
CT
101YP2500X
Professional Counselor
Primary
001894
CT
Other
Enumeration date
09/08/2010
Last updated
02/22/2012
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