1073551628 NPI number — MS. DIANNE DOBBS DAUBLER MSW LISW CP CEAP

Table of content: MS. DIANNE DOBBS DAUBLER MSW LISW CP CEAP (NPI 1073551628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073551628 NPI number — MS. DIANNE DOBBS DAUBLER MSW LISW CP CEAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAUBLER
Provider First Name:
DIANNE
Provider Middle Name:
DOBBS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LISW CP CEAP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073551628
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 SILVER FOX TRAIL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIMPSONVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29681
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-884-7642
Provider Business Mailing Address Fax Number:
864-627-8754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3150 SOUTH HIGHWAY 14
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-884-7642
Provider Business Practice Location Address Fax Number:
864-627-8754
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  SC7200 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SC7200 . This is a "SC HLT RELATED BRD OF SW" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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