Individual
DOMINIQUE GREENE-COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 MADISON AVE, COVINGTON, KY 41011-3330
(859) 360-0254
Mailing address
1717 MADISON AVE, COVINGTON, KY 41011-3330
(859) 360-0254
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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