Doctor Name: | DR. THOMAS JOSEPH DUBRAVA |
NPI Number: | 1881819324 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 3493 |
Business Practice Address: | 4301 State Route 725 Suite B Bellbrook, OH - 453051552 |
Business Phone Number: | 9378489858 |
Business Fax Number: | 9378482080 |
Mailing Address: | 2007 Avon Drive, BEAVERCREEK |
State: | OH |
Postal Code: | 454313301 |
Phone Number: | 9373201903 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3493 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |