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General NPI Number Information
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NPI Number | 1952771578
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Entity Type | Individual
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Provider Name | DUSTIN ROSS KEBRE M.A; LMFT
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Gender | Male
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Dates
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Enumeration Date | 09/25/2015
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 7940 N FEDERAL HWY SUITE 120
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City | BOCA RATON
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State | FL
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Zip | 33487-1679
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Country | US
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Telephone | 310-594-9974
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Fax |
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Provider Business Mailing Address
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Address Line | 17723 TIFFANY TRACE DR
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City | BOCA RATON
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State | FL
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Zip | 33487-1225
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Country | US
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Telephone | 310-594-9974
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3057
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License Number State | FL
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