| Duran Deffley, Llc | |
|
5 Executive Cir Savannah GA 31406-3345 | |
| (912) 312-0079 | |
| Not Available |
| Full Name | Duran Deffley, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5 Executive Cir, Savannah, Georgia |
| Authorized Official Name and Position | Ruth Duran Deffley (PSYCHOTHERAPIST) |
| Authorized Official Contact | 9123120079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duran Deffley, Llc 614 E 51st St Savannah GA 31405-2461 Ph: (912) 312-0079 | Duran Deffley, Llc 5 Executive Cir Savannah GA 31406-3345 Ph: (912) 312-0079 |
| NPI Number | 1891303533 |
|---|---|
| Provider Enumeration Date | 07/20/2020 |
| Last Update Date | 07/27/2020 |
| Certification Date | 07/27/2020 |
| Medicare PECOS PAC ID | 0840604534 |
|---|---|
| Medicare Enrollment ID | O20210120001336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891303533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ruth Duran Deffley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538643481 PECOS PAC ID: 2668886359 Enrollment ID: I20210120001531 |
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