Individual
LUIS DUQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCSP
Contact information
Practice address
1212 VFW PKWY, SUITE # 19, WEST ROXBURY, MA 02132-4309
(617) 970-3002
Mailing address
1212 VFW PARKWAY, SUITE # 19, WEST ROXBURY, MA 02132-4309
(617) 970-3002
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
377754
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
377754
DEPARTMENT OF EDUCATION--LIC SCH PSYCHOLOGIST
MA
01
—
38039
NCSP--NATIONALLY CERTIFIED SCHOOL PSYCHOLOGIST
—
Enumeration date
06/23/2009
Last updated
06/23/2009
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