Provider Demographics
NPI:1255578084
Name:SHUFELT, DAFNEY ADELLE (MAC, LICAC)
Entity type:Individual
Prefix:MS
First Name:DAFNEY
Middle Name:ADELLE
Last Name:SHUFELT
Suffix:
Gender:F
Credentials:MAC, LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472
Mailing Address - Country:US
Mailing Address - Phone:617-571-9577
Mailing Address - Fax:
Practice Address - Street 1:180 MASS. AVE.
Practice Address - Street 2:SUITE 301
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474
Practice Address - Country:US
Practice Address - Phone:617-571-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230076171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist