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NPI 1487731014

NPI 1487731014 : DENISE M DUKE ED.D., LP : MOORHEAD, MN

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General NPI Number Information
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    NPI Number           |    1487731014
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    Entity Type          |    Individual 
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    Provider Name        |    DENISE M DUKE ED.D., LP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/01/2006
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    Last Update Date     |    07/26/2023
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Provider Practice Location Address
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    Address Line         |    3101 8TH ST S 
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    City                 |    MOORHEAD
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    State                |    MN
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    Zip                  |    56560-5062
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    Country              |    US
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    Telephone            |    701-241-9281
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    Fax                  |    701-298-8321
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Provider Business Mailing Address
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    Address Line         |    3101 8TH ST S 
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    City                 |    MOORHEAD
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    State                |    MN
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    Zip                  |    56560-5062
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    Country              |    US
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    Telephone            |    701-241-9281
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    Fax                  |    701-298-8321
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    LP3533
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    License Number State |    MN
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