Individual
DARLENE DESSOURCES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
681 SW FREDRICA ST, PORT ST LUCIE, FL 34983-1875
(954) 655-9682
(888) 988-2894
Mailing address
PO BOX 882012, PORT ST LUCIE, FL 34988-2012
(954) 655-9682
(888) 988-2894
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
234634
FL
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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