Healthcare Provider Details

I. General information

NPI: 1316852254
Provider Name (Legal Business Name): SHAE DUFFY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 STANFORD DR
FARMINGTON CT
06032-2474
US

IV. Provider business mailing address

13 MARK LN
ROCKY HILL CT
06067-1138
US

V. Phone/Fax

Practice location:
  • Phone: 860-321-8604
  • Fax:
Mailing address:
  • Phone: 860-321-8604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: