Provider Demographics
NPI:1194897959
Name:DUNCAN, ANGEL FAYE (MAE)
Entity type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:FAYE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MAE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 HOMESTEAD CT
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-7403
Mailing Address - Country:US
Mailing Address - Phone:270-622-3777
Mailing Address - Fax:270-622-3445
Practice Address - Street 1:147 HOMESTEAD COURT
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164
Practice Address - Country:US
Practice Address - Phone:270-622-3777
Practice Address - Fax:270-622-3445
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY200116097222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist