Individual
MS. DOMONIQUE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13226 RUSTIC GARDEN DR, HOUSTON, TX 77083-0104
(832) 288-1931
Mailing address
13226 RUSTIC GARDEN DR, HOUSTON, TX 77083-0104
(832) 288-1931
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/22/2015
Last updated
05/22/2015
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