Individual
DOMINIQUE S PAUL-THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 DEERCREEK PARKWAY, GRIFFIN, GA 30224
(470) 771-2007
Mailing address
112 DEERCREEK PARKWAY, GRIFFIN, GA 30224
(470) 771-2007
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
—
—
251E00000X
Home Health Agency
Primary
—
GA
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
09/16/2019
Last updated
09/16/2019
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