Individual
AMBER DUBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 W 36TH ST, 8TH FLOOR, NEW YORK, NY 10018-7555
(212) 378-4545
Mailing address
255 W 36TH ST, 8TH FLOOR, NEW YORK, NY 10018-7555
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
070978-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104968692
NPI
NY
01
—
251S00000X
TAXONOMY CODE
NY
Enumeration date
12/04/2014
Last updated
12/04/2014
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