Healthcare Provider Details

I. General information

NPI: 1760497424
Provider Name (Legal Business Name): DUKE UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W MAIN ST SUITE 400A
DURHAM NC
27705-4640
US

IV. Provider business mailing address

2200 W MAIN ST SUITE 400A
DURHAM NC
27705-4640
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-1244
  • Fax: 919-286-1121
Mailing address:
  • Phone: 919-286-1244
  • Fax: 919-286-1121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDITH CLAIRE HOLDER-COOPER
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 919-286-1244