Provider Demographics
NPI:1720225972
Name:DUQUETTE, KYLE LYNN (LMFT)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:LYNN
Last Name:DUQUETTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:TOIVOLA
Mailing Address - State:MI
Mailing Address - Zip Code:49965-0074
Mailing Address - Country:US
Mailing Address - Phone:906-281-9999
Mailing Address - Fax:
Practice Address - Street 1:902 RAZORBACK DR STE 5
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-2802
Practice Address - Country:US
Practice Address - Phone:906-281-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006686106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist