Provider Demographics
NPI:1003059452
Name:DUNCAN, DWIGHT (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:DWIGHT
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 S LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4127
Mailing Address - Country:US
Mailing Address - Phone:303-733-3764
Mailing Address - Fax:303-733-0868
Practice Address - Street 1:895 S LOGAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-4127
Practice Address - Country:US
Practice Address - Phone:303-733-3764
Practice Address - Fax:303-733-0868
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1357103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical