Provider Demographics
NPI:1275232548
Name:DUFRESNE, HEATHER LYNNE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNNE
Last Name:DUFRESNE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNNE
Other - Last Name:OBIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:5436 BORGASE LN
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:NY
Mailing Address - Zip Code:13041-8906
Mailing Address - Country:US
Mailing Address - Phone:315-634-1100
Mailing Address - Fax:
Practice Address - Street 1:5436 BORGASE LN
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:NY
Practice Address - Zip Code:13041-8906
Practice Address - Country:US
Practice Address - Phone:315-634-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker