Provider Demographics
NPI:1912542416
Name:DUFRENE, ABBIE LYNN
Entity Type:Individual
Prefix:MS
First Name:ABBIE
Middle Name:LYNN
Last Name:DUFRENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 MAINE ST APT 11
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2070
Mailing Address - Country:US
Mailing Address - Phone:985-974-1507
Mailing Address - Fax:
Practice Address - Street 1:62 PEGASUS ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-5028
Practice Address - Country:US
Practice Address - Phone:207-373-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC18363104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker