Provider Demographics
NPI:1487601688
Name:DUBOY, MARIA E (LMHC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:DUBOY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 SW LAKEHURST DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2551
Mailing Address - Country:US
Mailing Address - Phone:772-336-3384
Mailing Address - Fax:
Practice Address - Street 1:7410 S US HIGHWAY 1
Practice Address - Street 2:SUITE 306
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-1432
Practice Address - Country:US
Practice Address - Phone:772-873-0015
Practice Address - Fax:772-873-6999
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6342101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ108AOtherBCBS PROVIDER NUMBER