Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 13739 | TX |
NPI | 1003430919 |
---|---|
Provider Name | Debra Dusek |
First Address | Brownwood, TX 76801-1265 |
Second Address | Brownwood, TX 76801-1265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2020 |
Last Update Date | 05/06/2020 |