Individual
JOHN A DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LP
Contact information
Practice address
3401 BERRYWOOD DR STE 203, COLUMBIA, MO 65201-6515
(573) 773-8330
(573) 777-8380
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2014001368
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490025695
—
MO
Enumeration date
10/02/2014
Last updated
05/10/2026
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