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NPI Code Detail

MEDICARE: AMANDA JOY DUFTY

MEDICARE: AMANDA JOY DUFTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801120126MI

General Provider Information

NPI Number : 1306364930
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JOY DUFTY
Provider Business Mailing Address
First Line : 415 MILL RD BLDG A
Second Line :
City : ADRIAN
State : MI
Zip : 49221-1764
Country : US
Telephone Number : 313-333-7869
Fax Number : 828-696-1794
Provider Business Practice Location Address
First Line : 415 MILL RD BLDG A
Second Line :
City : ADRIAN
State : MI
Zip : 49221-1764
Country : US
Telephone Number : 313-333-7869
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2017
Last Update Date : 06/20/2025

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Directions to “ AMANDA JOY DUFTY ” Practice Location

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