MEDICARE: KARLA DUBON

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	101YP2500X	Professional Counselor	2020011765	MO

General Provider Information

NPI Number	:	1457977647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA DUBON

Provider Business Mailing Address
First Line	:	10509 HICKMAN MILLS DR APT 14
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64137-1671
Country	:	US
Telephone Number	:	573-337-4908
Fax Number	:

Provider Business Practice Location Address
First Line	:	3737 S ELIZABETH ST STE 100
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-1785
Country	:	US
Telephone Number	:	844-424-9577
Fax Number	:

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

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	06/23/2020

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Directions to “ KARLA DUBON ” Practice Location

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