Organization Name: | E ANNE DUBOIS M ED, PA |
NPI Number: | 1235593963 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | E ANNE DUBOIS (PRESIDENT) |
Mailing Address: | 2194 Highway A1a Suite 203 Indian Harbour Beach |
State: | FL US |
Postal Code: | 329374930 |
Phone Number: | 3217778930 |
Fax Number: | 3217735479 |
NPI Enumeration Date: | 04/08/2016 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1551 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |