Provider Demographics
NPI:1689959918
Name:DUGGINS, JEANNE E (LISW)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:E
Last Name:DUGGINS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 PASEO VISTA LOOP NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4549
Mailing Address - Country:US
Mailing Address - Phone:505-259-2802
Mailing Address - Fax:505-892-2380
Practice Address - Street 1:425 PASEO VISTA LOOP NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4549
Practice Address - Country:US
Practice Address - Phone:505-259-2802
Practice Address - Fax:505-892-2380
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-075531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical