Provider Information for 1215514708
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Mrs. JILL SECREAST DUFFY LCSW
Sex: Female
NPI: 1215514708
Last Updated: 2021-03-29
Certification Date: 2021-03-29
Certification Date: 2021-03-29
Details
| Name | Value | ||||||||
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| NPI | 1215514708 | ||||||||
| Enumeration Date | 2021-03-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6072 POWDER POINT DR HICKORY, NC 28601-9412 United States Phone: 828-270-5408 | Fax: | ||||||||
| Primary Practice Address | 6072 POWDER POINT DR HICKORY, NC 28601-9412 United States Phone: 828-855-0425 | Fax: | ||||||||
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