Provider Demographics
NPI:1740581933
Name:DUFFY-GRESLO, ROSEMARY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:DUFFY-GRESLO
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 1:620 N 34TH ST APT 519
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8681
Mailing Address - Country:US
Mailing Address - Phone:847-736-5477
Mailing Address - Fax:
Practice Address - Street 1:150 NICKERSON ST STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1634
Practice Address - Country:US
Practice Address - Phone:206-905-9507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60895588106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist