Healthcare Provider Details

I. General information

NPI: 1467055111
Provider Name (Legal Business Name): BARBARA DUBOIS AND ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 N MAIN ST STE 2A3
SOUTHINGTON CT
06489-2577
US

IV. Provider business mailing address

116 PETERS CIRCLE
SOUTHINGTON CT
06489-3700
US

V. Phone/Fax

Practice location:
  • Phone: 860-329-2534
  • Fax: 833-516-1880
Mailing address:
  • Phone: 860-302-0893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA J DUBOIS
Title or Position: OWNER, DIETITIAN/NUTRITIONIST
Credential: RDN
Phone: 860-302-0893