Individual
SUSANNA DUBOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
69 FEDERAL ST, 2ND FLOOR, PORTLAND, ME 04101-4260
(207) 774-0042
Mailing address
69 FEDERAL ST, 2ND FLOOR, PORTLAND, ME 04101-4260
(207) 774-0042
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC9108
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100194
ANTHEM
ME
01
—
7848905
AETNA
ME
Enumeration date
09/14/2007
Last updated
09/14/2007
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