Provider Demographics
NPI:1124406285
Name:DUPLISSEY, CASIE R (MA)
Entity Type:Individual
Prefix:
First Name:CASIE
Middle Name:R
Last Name:DUPLISSEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 N AZUSA AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1323 N AZUSA AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2019
Practice Address - Country:US
Practice Address - Phone:253-777-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-09
Last Update Date:2015-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program