Provider Demographics
NPI:1255095931
Name:PAYANT DUFFEK, ANNE MARIE (MS-MFT, MPH, MS-THAN)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:PAYANT DUFFEK
Suffix:
Gender:F
Credentials:MS-MFT, MPH, MS-THAN
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:PAYANT DUFFEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH
Mailing Address - Street 1:503 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54409-2222
Mailing Address - Country:US
Mailing Address - Phone:608-770-1310
Mailing Address - Fax:
Practice Address - Street 1:W10610 CLINIC ST
Practice Address - Street 2:
Practice Address - City:ELCHO
Practice Address - State:WI
Practice Address - Zip Code:54428-9619
Practice Address - Country:US
Practice Address - Phone:715-275-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist