Provider Demographics
NPI:1699473173
Name:JOSEPH-JARVIS, DESIREE C
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:C
Last Name:JOSEPH-JARVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3040
Mailing Address - Country:US
Mailing Address - Phone:973-487-9842
Mailing Address - Fax:
Practice Address - Street 1:276 PRESTON PL
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2524
Practice Address - Country:US
Practice Address - Phone:973-487-9842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst