Individual
JUDITH DUBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LCDP
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 274-2500
Mailing address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDP00658
RI
163W00000X
Registered Nurse
Primary
RN31644
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
01
—
1902846322
UBH
RI
05
—
JM54958
—
RI
Enumeration date
06/07/2006
Last updated
05/04/2021
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