Provider Demographics
NPI:1710153291
Name:DUQUETTE, JESSICA NICHOL (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:NICHOL
Last Name:DUQUETTE
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 POND LILY DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-8613
Mailing Address - Country:US
Mailing Address - Phone:406-600-6600
Mailing Address - Fax:406-219-0878
Practice Address - Street 1:200 POND LILY DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-8613
Practice Address - Country:US
Practice Address - Phone:406-600-6600
Practice Address - Fax:406-219-0878
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2687225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist