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NPI Code Detail

MEDICARE: REBECCA ANN DUFFY LAC

MEDICARE:   REBECCA ANN DUFFY  LAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLAC13872AZ

General Provider Information

NPI Number : 1851644074
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ANN DUFFY LAC
Provider Business Mailing Address
First Line : 4414 N 19TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-4114
Country : US
Telephone Number : 602-285-5550
Fax Number : 602-285-5551
Provider Business Practice Location Address
First Line : 4414 N 19TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-4114
Country : US
Telephone Number : 602-285-5550
Fax Number : 602-285-5551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2012
Last Update Date : 10/25/2012

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Directions to “ REBECCA ANN DUFFY LAC” Practice Location

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