Provider Demographics
NPI:1275597841
Name:DUPONT, NANCY H (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:H
Last Name:DUPONT
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:PINE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12567-5022
Mailing Address - Country:US
Mailing Address - Phone:917-848-3991
Mailing Address - Fax:518-398-1541
Practice Address - Street 1:54 RYAN RD
Practice Address - Street 2:
Practice Address - City:PINE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12567-5022
Practice Address - Country:US
Practice Address - Phone:518-398-0411
Practice Address - Fax:518-398-1541
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000102103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis