Healthcare Provider Details

I. General information

NPI: 1235593963
Provider Name (Legal Business Name): E ANNE DUBOIS M.ED, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 09/30/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 SOUTH PATRICK DRIVE, UNIT 1
SATELLITE BEACH FL
32937
US

IV. Provider business mailing address

195 SKYLINE BLVD
SATELLITE BEACH FL
32937-3264
US

V. Phone/Fax

Practice location:
  • Phone: 321-777-8930
  • Fax:
Mailing address:
  • Phone: 321-917-2987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1551
License Number StateFL

VIII. Authorized Official

Name: ELIZABETH ANNE DUBOIS
Title or Position: PRESIDENT
Credential: LMHC
Phone: 321-717-2987