Provider Demographics
NPI:1841926805
Name:DUCHEINE, MARJORICA
Entity type:Individual
Prefix:
First Name:MARJORICA
Middle Name:
Last Name:DUCHEINE
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 1:219 SADDLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT BETHEL
Mailing Address - State:PA
Mailing Address - Zip Code:18343-5788
Mailing Address - Country:US
Mailing Address - Phone:570-710-5334
Mailing Address - Fax:
Practice Address - Street 1:219 SADDLE CREEK DR
Practice Address - Street 2:
Practice Address - City:MOUNT BETHEL
Practice Address - State:PA
Practice Address - Zip Code:18343-5788
Practice Address - Country:US
Practice Address - Phone:570-710-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health