Provider Demographics
NPI:1427804152
Name:DURFEE, MARIA MELISSA (MSOM, LAC, DACM)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MELISSA
Last Name:DURFEE
Suffix:
Gender:F
Credentials:MSOM, LAC, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 COMMODORE PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3741
Mailing Address - Country:US
Mailing Address - Phone:808-557-5702
Mailing Address - Fax:
Practice Address - Street 1:650 TEN ROD RD STE G4
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4238
Practice Address - Country:US
Practice Address - Phone:808-557-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-1276-0171100000X
RIDACM00103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist