Organization
DOMINIQUE JAMISON-WILLAMS
Active
Organization
DOMINIQUE JAMISON-WILLAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE LASHANDA JAMISOM-WILLIAMS MSOTR (OCCUPATIONAL THERAPIST)
(219) 981-8551
Entity
Organization
Contact information
Practice address
6400 ARTHUR ST, MERRILLVILLE, IN 46410-3123
(219) 981-8551
Mailing address
6400 ARTHUR ST, MERRILLVILLE, IN 46410-3123
(219) 981-8551
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
31002428A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200610120
—
IN
05
—
200708930
—
IN
Enumeration date
05/24/2008
Last updated
05/24/2008
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