Individual
MYA DOMINIQUE LEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, QMHP-T
Contact information
Practice address
14 FORDHAM RD, ALLSTON, MA 02134-3000
(617) 782-6460
Mailing address
23 KENNEDY DR, RANDOLPH, MA 02368-3821
(781) 510-3236
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0734011681
VA
251S00000X
Community/Behavioral Health Agency
Primary
0734011681
VA
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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