Provider Demographics
NPI:1548417033
Name:DUFFY-PAIEMENT, CHRISTY B (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:B
Last Name:DUFFY-PAIEMENT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 6841
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47407-6841
Mailing Address - Country:US
Mailing Address - Phone:812-269-2181
Mailing Address - Fax:
Practice Address - Street 1:3210 E 10TH ST UNIT 6841
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47407-2785
Practice Address - Country:US
Practice Address - Phone:812-269-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042640A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist