Provider Demographics
NPI:1487939518
Name:MCDUFFEE, JENNIFER RYAN (LSW, MSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RYAN
Last Name:MCDUFFEE
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:85 CONTINENTAL DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3432
Mailing Address - Country:US
Mailing Address - Phone:775-324-5820
Mailing Address - Fax:775-324-5840
Practice Address - Street 1:85 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3432
Practice Address - Country:US
Practice Address - Phone:775-324-5820
Practice Address - Fax:775-324-5840
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5951-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV166957492OtherPIONEER HEALTH RESOURCES, INC.