Doctor Name: | WILLIAM J DUANE |
NPI Number: | 1003809500 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 0810000926 |
Business Practice Address: | Academy Crossing Medical Plaza 3300 Academy Avenue Portsmouth, VA - 237033205 |
Business Phone Number: | 7574836404 |
Business Fax Number: | 7574830737 |
Mailing Address: | Academy Crossing Medical Plaza, 3300 Academy Avenue PORTSMOUTH |
State: | VA |
Postal Code: | 237033205 |
Phone Number: | 7574836404 |
Fax Number: | 7574830737 |
NPI Enumeration Date: | 08/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0810000926 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |