Provider Demographics
NPI:1124172226
Name:DUFFY, JOANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
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 1:2411 W BELVEDERE AVE STE 504
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5232
Mailing Address - Country:US
Mailing Address - Phone:410-601-0070
Mailing Address - Fax:410-601-0290
Practice Address - Street 1:2411 W BELVEDERE AVE STE 504
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5232
Practice Address - Country:US
Practice Address - Phone:410-601-0070
Practice Address - Fax:410-601-0290
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist