Doctor Name: | MARY-THERESE C DUFFY |
NPI Number: | 1205968518 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | CC1997 |
Business Practice Address: | 157 Valley Rd Raymond, ME - 040716163 |
Business Phone Number: | 2077126200 |
Business Fax Number: | |
Mailing Address: | 157 Valley Rd, RAYMOND |
State: | ME |
Postal Code: | 040716163 |
Phone Number: | 2077126200 |
Fax Number: | |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 11/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | CC1997 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |