Individual
SHANETTE LOUISE DOMINICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
702 HIGHLAND VIEW DR, YOUNGSVILLE, LA 70592-6185
(337) 452-9795
Mailing address
702 HIGHLAND VIEW DR, YOUNGSVILLE, LA 70592-6185
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LSSP017
LA
103TC1900X
Counseling Psychologist
—
—
Other
Enumeration date
11/25/2017
Last updated
03/22/2024
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