Provider Demographics
NPI:1750625596
Name:DUBASIK, VALENTINA KHOURY (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:VALENTINA
Middle Name:KHOURY
Last Name:DUBASIK
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2458 DEMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3620
Mailing Address - Country:US
Mailing Address - Phone:330-307-7358
Mailing Address - Fax:
Practice Address - Street 1:755 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE D3
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4300
Practice Address - Country:US
Practice Address - Phone:330-729-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-17
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1347175F00000X
OH65.000311171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath