Individual
DEBRA DUBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LICENSED CLINICA
Contact information
Practice address
1720 N PACE BLVD, PENSACOLA, FL 32505-6032
(850) 723-0042
Mailing address
1720 N PACE BLVD, PENSACOLA, FL 32505-6032
(850) 723-0042
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
47-1121769
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW 4505
STATE OF FLORIDA DEPARMENT OF HEALTH
FL
Enumeration date
09/09/2014
Last updated
09/09/2014
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