Provider Demographics
NPI:1134220635
Name:DUFFANY, ADRIENNE I (CSW)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:I
Last Name:DUFFANY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 E 1600 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-7834
Mailing Address - Country:US
Mailing Address - Phone:801-318-6479
Mailing Address - Fax:801-375-4045
Practice Address - Street 1:1161 E 300 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-3539
Practice Address - Country:US
Practice Address - Phone:801-852-4514
Practice Address - Fax:801-375-4045
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5137253-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical