Individual
SUSAN DOMINGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
116 BERTRAND DR STE 100, LAFAYETTE, LA 70506-5632
(337) 261-8781
Mailing address
9802 COTTON LOOP, ABBEVILLE, LA 70510-2110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
9033
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/29/2015
Last updated
06/18/2024
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