Provider Demographics
NPI:1649084104
Name:DURAN, AMAIYAH
Entity type:Individual
Prefix:
First Name:AMAIYAH
Middle Name:
Last Name:DURAN
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 1:40 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01543-1731
Mailing Address - Country:US
Mailing Address - Phone:774-364-1270
Mailing Address - Fax:
Practice Address - Street 1:40 JUNIPER LN
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:MA
Practice Address - Zip Code:01543-1731
Practice Address - Country:US
Practice Address - Phone:774-364-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician