Provider Demographics
NPI:1376279687
Name:DUFIELD, NICOLE D
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:D
Last Name:DUFIELD
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 1:364 MCLAWS CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6340
Mailing Address - Country:US
Mailing Address - Phone:757-870-5571
Mailing Address - Fax:
Practice Address - Street 1:364 MCLAWS CIR STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6340
Practice Address - Country:US
Practice Address - Phone:757-870-5571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704015028101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health