Individual
CLESHAUN A DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LAC-19354
AZ
Other
Enumeration date
11/02/2020
Last updated
06/07/2022
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