Provider Demographics
NPI:1902424310
Name:DUBE, MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:
Last Name:DUBE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 STANTON AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-2458
Mailing Address - Country:US
Mailing Address - Phone:609-254-6527
Mailing Address - Fax:
Practice Address - Street 1:954 STANTON AVE
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-2458
Practice Address - Country:US
Practice Address - Phone:609-254-6527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0000350101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health