Individual
ANDREA R DOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1361 ELM ST STE 400, MANCHESTER, NH 03101-1323
(603) 232-6987
Mailing address
11 CLEAR CREEK WAY, MANCHESTER, NH 03102-8462
(603) 793-8029
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1205
NH
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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