Individual
DOMINIQUE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 LATROBE DR STE B, CHARLOTTE, NC 28211-5227
(704) 780-4271
Mailing address
6828 BEREWICK COMMONS PKWY, CHARLOTTE, NC 28278-6742
(704) 253-0395
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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