Provider Demographics
NPI:1851712673
Name:DUFFNEY, CAITLIN GILL (CAITLIN)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:GILL
Last Name:DUFFNEY
Suffix:
Gender:F
Credentials:CAITLIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3771 SAN JOSE PL
Mailing Address - Street 2:STE 22
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-2436
Mailing Address - Country:US
Mailing Address - Phone:904-928-9112
Mailing Address - Fax:904-928-9112
Practice Address - Street 1:6789 SOUTHPOINT PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8205
Practice Address - Country:US
Practice Address - Phone:904-556-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-20
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist