Basic Information
| Provider Information | |||||||||
| NPI: | 1508045865 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUBEY | ||||||||
| FirstName: | JANEEN | ||||||||
| MiddleName: | NOELLA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 789 N CLARE AVE | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486259194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895392124 | ||||||||
| FaxNumber: | 9895392143 | ||||||||
| Practice Location | |||||||||
| Address1: | 789 N CLARE AVE | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486259194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895392124 | ||||||||
| FaxNumber: | 9895392143 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2007 | ||||||||
| LastUpdateDate: | 11/02/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC1900X | 6301012510 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.