Provider Demographics
NPI:1326279282
Name:DUNCKEL, JEANNETTE LYNNE
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:LYNNE
Last Name:DUNCKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COURT ST
Mailing Address - Street 2:SUITE 42
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1695
Mailing Address - Country:US
Mailing Address - Phone:607-337-1600
Mailing Address - Fax:
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:SUITE 42
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-337-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health