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Organization
SOTM LIFE SKILLS CENTER, LLC
Active
Organization
SOTM LIFE SKILLS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOMINIQUE DOR LPC (LICENSED PROFESSIONAL COUNSELOR)
(972) 709-1180
Entity
Organization
Contact information
Practice address
549 W WHEATLAND RD, DUNCANVILLE, TX 75116-4515
(972) 709-1180
(972) 709-1180
Mailing address
549 W WHEATLAND RD, DUNCANVILLE, TX 75116-4515
(972) 709-1180
(972) 709-1180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
66598
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3286940
—
TX
Enumeration date
07/05/2014
Last updated
07/05/2014
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