Provider Demographics
NPI:1821712860
Name:DUNCANSON, KATHLEEN CLAIRE (MS, ATC/L, OPE-C)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:CLAIRE
Last Name:DUNCANSON
Suffix:
Gender:F
Credentials:MS, ATC/L, OPE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:YOUNG HARRIS
Mailing Address - State:GA
Mailing Address - Zip Code:30582-4137
Mailing Address - Country:US
Mailing Address - Phone:407-451-3855
Mailing Address - Fax:
Practice Address - Street 1:1 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:YOUNG HARRIS
Practice Address - State:GA
Practice Address - Zip Code:30582-4137
Practice Address - Country:US
Practice Address - Phone:407-451-3855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0029612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer