Provider Demographics
NPI:1851375497
Name:DEMMER, DARLENE T (MSW)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:T
Last Name:DEMMER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 E BASELINE RD
Mailing Address - Street 2:STE F4
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1516
Mailing Address - Country:US
Mailing Address - Phone:480-756-9455
Mailing Address - Fax:480-756-9456
Practice Address - Street 1:2111 E BASELINE RD
Practice Address - Street 2:STE F4
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1516
Practice Address - Country:US
Practice Address - Phone:480-756-9455
Practice Address - Fax:480-756-9456
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW19241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical