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Individual

DOMINIQUE LEE FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 345-6388
Mailing address
152 CHASTE TREE CIR, GOOSE CREEK, SC 29445-7371
(843) 345-6388

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12693
SC

Other

Enumeration date
07/26/2022
Last updated
07/26/2022
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