Provider Demographics
NPI:1659809465
Name:DUENAS, MELISSA (CLC, CBD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:DUENAS
Suffix:
Gender:F
Credentials:CLC, CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 VERNON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3697
Mailing Address - Country:US
Mailing Address - Phone:860-890-3970
Mailing Address - Fax:
Practice Address - Street 1:14 VINE ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1431
Practice Address - Country:US
Practice Address - Phone:860-890-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula