=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194380634
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RACHEL A. DUBRASKI, LMFT, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2019
-----------------------------------------------------
Last Update Date | 05/09/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 735 POST RD E
-----------------------------------------------------
City | WESTPORT
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06880-5238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-994-9870
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 735 POST RD E
-----------------------------------------------------
City | WESTPORT
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06880-5238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-601-6157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MARRIAGE AND FAMILY THERAPIST
-----------------------------------------------------
Name | RACHEL A DUBRASKI
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 203-601-6157
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------