Fallyn Duque, MS ATR

Primary specialty

Art TherapistTaxonomy code 221700000X

License

20936 Issued in WI

Practice address

W274 Hillendale Dr
Oconomowoc, WI 53066-5528

Phone

(262) 352-2913

NPI assigned

Jul 8, 2019

Last updated

Dec 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1295397560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W274 HILLENDALE DR",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530665528",
            "telephone_number": "262-352-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W274 HILLENDALE DR",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530665528",
            "telephone_number": "262-352-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUQUE",
        "first_name": "FALLYN",
        "credential": "MS ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "WI",
            "license": "20936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brady Robert Dorn, DC
• Roby Christian Dorn, D.C.
• DRS. Leaman, Setnicar & Piacsek, S.C.
• Joann C Dudley, MD
• Nicole Dunbar, LPC-IT
• Erin L Eckes
• Edp of Wisconsin, SC (Drs. Leaman, Setnicar & Piacsek)
• Angela Eggleston, PHARMD
• Howard V. Elconin, M.D.
• Shayla Ellingboe

• Art Therapist in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Art Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.