Healthcare Provider Details

I. General information

NPI: 1407785660
Provider Name (Legal Business Name): MRS. JASMINE MARIE DUBOSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 E EXCHANGE ST FL 6
AKRON OH
44308-1541
US

IV. Provider business mailing address

12 E EXCHANGE ST FL 6
AKRON OH
44308-1541
US

V. Phone/Fax

Practice location:
  • Phone: 234-334-3293
  • Fax: 234-208-8074
Mailing address:
  • Phone: 234-334-3293
  • Fax: 234-208-8074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: