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NPI Code Detail

MEDICARE: MS. LYNN E DUFFIELD MSW., LCSW

MEDICARE: MS. LYNN E DUFFIELD MSW., LCSW
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
1101Y00000XCounselor2002025684MO

General Provider Information

NPI Number : 1588757686
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LYNN E DUFFIELD MSW., LCSW
Provider Business Mailing Address
First Line : 8631 DELMAR BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63124-1990
Country : US
Telephone Number : 314-787-5100
Fax Number : 314-754-2800
Provider Business Practice Location Address
First Line : 8631 DELMAR BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63124-1990
Country : US
Telephone Number : 314-787-5100
Fax Number : 314-754-2800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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