Dubose, Kim Teresa

Dubose, Kim Teresa is an individual health care provider with primary practice located at 609 Hilchot Dr , Summerville SC 29486-2426. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Student, Health Care / Student in an Organized Health Care Education/Training Program. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dubose, Kim Teresa can be contacted via phone (843) 758-4570.

Contact Information

Primary practice address
609 Hilchot Dr Summerville SC 29486-2426
Phone: (843) 758-4570
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X S.1701335 Ohio
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 13979 South Carolina

Profile Details

NPI number 1811366677
LBN Legal business name Dubose, Kim Teresa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2015
Last updated Nov 16th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811366677 NPPES
Ohio MEDICAID 0297228

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