Provider Demographics
NPI:1851680631
Name:DUFFY, PATRICIA LORRAINE (PSYD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LORRAINE
Last Name:DUFFY
Suffix:
Gender:F
Credentials:PSYD
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 217
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-0003
Mailing Address - Country:US
Mailing Address - Phone:781-718-1061
Mailing Address - Fax:
Practice Address - Street 1:19 MUZZEY ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5256
Practice Address - Country:US
Practice Address - Phone:781-718-1061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9319103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist