Provider Demographics
NPI:1356551584
Name:DURKEE, MAUREEN TERESA (ATR, MFT)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:TERESA
Last Name:DURKEE
Suffix:
Gender:F
Credentials:ATR, MFT
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 442
Mailing Address - Street 2:
Mailing Address - City:SANTA YSABEL
Mailing Address - State:CA
Mailing Address - Zip Code:92070-0442
Mailing Address - Country:US
Mailing Address - Phone:760-765-0134
Mailing Address - Fax:
Practice Address - Street 1:300 S IMPERIAL AVE
Practice Address - Street 2:SUITE NUMBER 6
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-3149
Practice Address - Country:US
Practice Address - Phone:760-765-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22666106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist