Individual
NIECY MICHELLE DOMINIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3111 LONG BLVD APT B207, NASHVILLE, TN 37203-1711
(770) 940-4677
Mailing address
3111 LONG BLVD APT B207, NASHVILLE, TN 37203-1711
(770) 940-4677
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12665
TN
104100000X
Social Worker
6611G
AL
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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