Provider Demographics
NPI:1285661017
Name:DUFFY, TRISHA LEE (MA)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:LEE
Last Name:DUFFY
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 1:11470 N 300 E
Mailing Address - Street 2:
Mailing Address - City:N MANCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46962-8941
Mailing Address - Country:US
Mailing Address - Phone:290-982-8676
Mailing Address - Fax:765-677-5116
Practice Address - Street 1:1700 E 38TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4568
Practice Address - Country:US
Practice Address - Phone:765-677-3143
Practice Address - Fax:765-677-5116
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002335A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist