Dr. James Todd Dubose, Ph.D.
Psychologist, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1013133479
StatusActive
Last updated in NPPESOct 29, 2010
Details
- NPI
- 1013133479
- Entity type
- Individual (NPI-1)
- Name
- Dr. James Todd Dubose
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 17, 2007
- Last updated
- Oct 29, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 71007252 | IL | Yes |
Practice location
222 Merchandise Mart PlzSuite 13-659, Office # 1336
Chicago, IL 60654-1103
Phone 312-329-6694
Mailing address
325 North Wells StreetChicago, IL 60654
Phone 312-329-6694
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