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NPI Code Detail

MEDICARE: KORTNI DUBOSE PHD

MEDICARE: KORTNI DUBOSE PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent PsychologistP.08802OH
2103T00000XPsychologistP.08802OH

General Provider Information

NPI Number : 1154108868
Entity Type Code : Individual
Provider Name (Legal Business Name) : KORTNI DUBOSE PHD
Provider Business Mailing Address
First Line : 2722 ERIE AVE STE 219
Second Line :
City : CINCINNATI
State : OH
Zip : 45208-2154
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2722 ERIE AVE STE 219
Second Line :
City : CINCINNATI
State : OH
Zip : 45208-2154
Country : US
Telephone Number : 614-398-0011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2023
Last Update Date : 12/02/2025

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Directions to “ KORTNI DUBOSE PHD” Practice Location

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