Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 60933 | TX |
NPI | 1003116195 |
---|---|
Provider Name | Ms. Deborah Dubois |
First Address | Waco, TX 76710-4359 |
Second Address | Waco, TX 76710-4359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2010 |
Last Update Date | 24/10/2010 |