Individual
DOMINIQUE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6005 PARK MANOR DR, DALLAS, TX 75241-5241
(972) 277-7517
Mailing address
3655 SIMPSON STUART RD UNIT 411123, DALLAS, TX 75241-4377
(318) 605-1784
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/04/2018
Last updated
03/06/2023
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