Provider Demographics
NPI:1649093147
Name:DUFFY, MAUREEN PATRICIA (PHD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:PATRICIA
Last Name:DUFFY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2464
Mailing Address - Country:US
Mailing Address - Phone:305-335-8043
Mailing Address - Fax:
Practice Address - Street 1:501 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2464
Practice Address - Country:US
Practice Address - Phone:305-335-8043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT0000577106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist