Individual
DOMINIQUE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, MSW U/S
Contact information
Practice address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(539) 202-3832
Mailing address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(539) 202-3832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7523
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/09/2016
Last updated
12/03/2021
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