Provider Demographics
NPI:1871754663
Name:DUBRAY, DEE ANN (MSW)
Entity type:Individual
Prefix:
First Name:DEE
Middle Name:ANN
Last Name:DUBRAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DEEANN
Other - Middle Name:
Other - Last Name:DUBRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:40520 CTOUNTY HIGHWAY 34
Mailing Address - Street 2:WHITE EARTH HEALTH CENTER
Mailing Address - City:OGEMA
Mailing Address - State:MN
Mailing Address - Zip Code:56569-9612
Mailing Address - Country:US
Mailing Address - Phone:218-983-4300
Mailing Address - Fax:218-983-6217
Practice Address - Street 1:40520 COUNTY HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:OGEMA
Practice Address - State:MN
Practice Address - Zip Code:56569-9612
Practice Address - Country:US
Practice Address - Phone:218-983-4300
Practice Address - Fax:218-983-6217
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3548104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN076685200Medicaid