Individual
JENNIFER L. DESJARDINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHRT-C
Contact information
Practice address
31 MARKET ST, FORT KENT, ME 04743-1418
(207) 436-7027
Mailing address
175 STRIP RD, PO BOX 314, FORT KENT, ME 04743-1552
(207) 436-7027
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC5168
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103850000
MAINECARE
ME
Enumeration date
09/19/2007
Last updated
11/13/2012
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