Provider Demographics
NPI:1346515293
Name:DUQUETTE, AMY VICTORIA (MPS, ATR-BC, LCAT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:VICTORIA
Last Name:DUQUETTE
Suffix:
Gender:F
Credentials:MPS, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 MYRTLE AVE APT 3R
Mailing Address - Street 2:APT 3R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-2489
Mailing Address - Country:US
Mailing Address - Phone:917-439-4351
Mailing Address - Fax:
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:SUITE 237
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:917-439-4351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000233-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist