Provider Demographics
NPI:1780885418
Name:DUMBOLA, DAVID MARK (BA, LCDC III)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MARK
Last Name:DUMBOLA
Suffix:
Gender:M
Credentials:BA, LCDC III
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Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:BEHAVIORAL MEDICINE 2ND FLOOR
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7024
Mailing Address - Fax:740-283-7853
Practice Address - Street 1:380 SUMMIT AVE
Practice Address - Street 2:BEHAVIORAL MEDICINE 2ND FLOOR
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2667
Practice Address - Country:US
Practice Address - Phone:740-283-7024
Practice Address - Fax:740-283-7853
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH976070101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)