Individual
MISS ANDREA LYNN DOMINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S, LICDC
Contact information
Practice address
205 HOSPITAL DR, DOVER, OH 44622-2058
(330) 343-7950
Mailing address
659 BOULEVARD ST, DOVER, OH 44622-2026
(330) 343-3311
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
111001
OH
101YM0800X
Mental Health Counselor
Primary
E.0600629 SUPV
OH
Other
Enumeration date
02/28/2007
Last updated
05/20/2020
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