Individual
DOMINIQUE IVORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11861 COURSEY BLVD, BATON ROUGE, LA 70816-4404
(225) 612-8656
(225) 341-8774
Mailing address
11861 COURSEY BLVD, BATON ROUGE, LA 70816-4404
(225) 612-8656
(225) 341-8774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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