Individual
DR. LAUREN ALEXIS FORMY-DUVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1502 W NC HIGHWAY 54, SUITE 302, DURHAM, NC 27707-5571
(919) 475-9629
Mailing address
1502 W NC HIGHWAY 54, SUITE 302, DURHAM, NC 27707-5571
(919) 475-9629
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3357
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14067
BLUECROSS AND BLUESHIELD
NC
01
—
2397097
CIGNA
NC
05
—
6001043
—
NC
Enumeration date
01/23/2007
Last updated
02/10/2010
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