Provider Demographics
NPI:1720078538
Name:DUFFER, SHELBY MARIE (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:MARIE
Last Name:DUFFER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4623
Mailing Address - Country:US
Mailing Address - Phone:703-698-3916
Mailing Address - Fax:703-698-1137
Practice Address - Street 1:3015 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4623
Practice Address - Country:US
Practice Address - Phone:703-698-3916
Practice Address - Fax:703-698-1137
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS