Individual
MR. CARL EDWARD DUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
151 W BRUNDAGE ST, SHERIDAN, WY 82801-4217
(307) 674-1668
Mailing address
151 W BRUNDAGE ST, SHERIDAN, WY 82801-4217
(307) 674-1668
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PPC-1169
WY
101YP2500X
Professional Counselor
Primary
LPC-1963
WY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/08/2016
Last updated
07/04/2021
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