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Individual

DOMINIQUE DESMOND FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
9985 POPLAR TENT RO, HUNTERSVILLE, NC 28027
(704) 774-8424
Mailing address
9985 POPLAR TENT RD HUNTERSVILLE,, HUNTERSVILLE, NC 28027
(704) 774-8424

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
04/11/2023
Last updated
04/17/2026
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