MEDICARE: CAMILIA LUISA DUGAY LCDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1386238376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILIA LUISA DUGAY LCDC

Provider Business Mailing Address
First Line	:	2727 TRAVIS ST APT 730
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-3592
Country	:	US
Telephone Number	:	832-598-7253
Fax Number	:	281-459-7651

Provider Business Practice Location Address
First Line	:	2727 TRAVIS ST APT 730
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-3592
Country	:	US
Telephone Number	:	832-598-7253
Fax Number	:	281-459-7651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2021
Last Update Date	:	02/22/2021

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