Individual
DOMONIQUE GHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
100 ENGLAND ST, ASHLAND, VA 23005-2013
(804) 368-8475
Mailing address
8319 MARWOOD DRIVE, NORTH CHESTERFIELD, VA 23235
(804) 687-0308
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119009849
VA
Other
Enumeration date
03/20/2023
Last updated
08/11/2024
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