Individual
SALLIE JANE DOMINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 SW D AVE, SUITE 5, LAWTON, OK 73501-4619
(580) 250-1222
(580) 250-1795
Mailing address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/17/2007
Last updated
07/08/2007
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