Provider Demographics
NPI:1497198576
Name:DUARTE, TAKEIA MARIE
Entity Type:Individual
Prefix:MRS
First Name:TAKEIA
Middle Name:MARIE
Last Name:DUARTE
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 1:1625 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-1771
Mailing Address - Country:US
Mailing Address - Phone:401-762-1511
Mailing Address - Fax:401-762-1609
Practice Address - Street 1:1625 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-1771
Practice Address - Country:US
Practice Address - Phone:401-762-1511
Practice Address - Fax:401-762-1609
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)