Provider Demographics
NPI:1972250348
Name:LEMIEUX, DESIREE LYNDA (LMA)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:LYNDA
Last Name:LEMIEUX
Suffix:
Gender:F
Credentials:LMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 POLKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07832-2775
Mailing Address - Country:US
Mailing Address - Phone:917-923-9889
Mailing Address - Fax:
Practice Address - Street 1:12 POLKVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:NJ
Practice Address - Zip Code:07832-2775
Practice Address - Country:US
Practice Address - Phone:917-923-9889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist