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Individual
KIM TERESA DUBOSE
Active
Individual
KIM TERESA DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13979
SC
1041C0700X
Clinical Social Worker
S.1701335
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0297228
—
OH
Enumeration date
09/22/2015
Last updated
11/16/2022
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