Individual
JANA MIREILLE DUFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
285 VANDERBILT AVE, STATEN ISLAND, NY 10304-2525
(718) 981-4382
Mailing address
285 VANDERBILT AVE, STATEN ISLAND, NY 10304-2525
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/16/2013
Last updated
05/16/2013
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