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General NPI Number Information
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NPI Number | 1295985604
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Entity Type | Individual
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Provider Name | JEANINE E DUFFY
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Gender | Female
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 61 MEDFORD ST
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City | SOMERVILLE
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State | MA
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Zip | 02143-3421
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Country | US
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Telephone | 617-629-3919
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Fax |
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Provider Business Mailing Address
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Address Line | 123 FREEMAN ST APT. 2A
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City | BROOKLINE
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State | MA
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Zip | 02446-3588
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Country | US
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Telephone | 617-605-5746
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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