Individual
DOMINIQUE LATRECE SQUIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
575 S SQUARE DR APT 103, WINTERVILLE, NC 28590-8699
(919) 423-7483
Mailing address
575 S SQUARE DR APT 103, WINTERVILLE, NC 28590-8699
(919) 423-7483
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C017135
NC
Other
Enumeration date
11/12/2020
Last updated
05/22/2024
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