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General NPI Number Information
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NPI Number | 1306118567
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Entity Type | Individual
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Provider Name | TRAVIS DUNCAN PSYD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 51 W HIGH ST
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City | WAYNESBURG
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State | PA
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Zip | 15370-1343
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Country | US
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Telephone | 724-627-0922
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Fax | 724-627-0940
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Provider Business Mailing Address
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Address Line | 110 S ARCH ST
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3515
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Country | US
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Telephone | 724-626-9941
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Fax | 724-626-2785
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | OH3044897
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | OH3044897
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License Number State | OH
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