Individual
MRS. NICOLE MAE DUBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5120 148TH CT, MIDLOTHIAN, IL 60445-3562
(609) 903-6643
Mailing address
5120 148TH CT, MIDLOTHIAN, IL 60445-3562
(609) 903-6643
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
09/07/2023
Last updated
09/11/2023
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