Provider Demographics
NPI:1588956205
Name:DUVAL, ERNEST C
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:C
Last Name:DUVAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3072 GRANDIFLORA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2008
Mailing Address - Country:US
Mailing Address - Phone:561-584-0609
Mailing Address - Fax:
Practice Address - Street 1:1551 FORUM PL
Practice Address - Street 2:SUITE D&E
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2319
Practice Address - Country:US
Practice Address - Phone:561-616-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor