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NPI Code Detail

MEDICARE: MR. TERRY LEON DUFFY LADC

MEDICARE: MR. TERRY LEON DUFFY LADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor919NE

General Provider Information

NPI Number : 1871872655
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TERRY LEON DUFFY LADC
Provider Business Mailing Address
First Line : 1800 W PASEWALK AVE STE A
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5657
Country : US
Telephone Number : 402-500-6870
Fax Number : 402-371-7483
Provider Business Practice Location Address
First Line : 1800 W PASEWALK AVE STE A
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5657
Country : US
Telephone Number : 402-500-6870
Fax Number : 402-371-7483
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2011
Last Update Date : 01/09/2023

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