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Individual
NICOLE MIGNON DUBUS
Active
Individual
NICOLE MIGNON DUBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110673
MA
1041C0700X
Clinical Social Worker
LCS15487
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049907
TRICARE
MA
01
—
104468
UBH
MA
05
—
1858751
—
MA
01
—
460265
TUFTS
MA
01
—
P07791
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/16/2006
Last updated
07/09/2007
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