Provider Demographics
NPI:1144590902
Name:DUNCAN, JEFFREY DAVID (LMFT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DAVID
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:88 N 100 E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-1629
Mailing Address - Country:US
Mailing Address - Phone:435-703-5776
Mailing Address - Fax:
Practice Address - Street 1:88 N 100 E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-1629
Practice Address - Country:US
Practice Address - Phone:435-703-5776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7795382-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist