Individual
DOMONIQUE GABRIELLE MINTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA TLLP
Contact information
Practice address
12956 LENORE, REDFORD, MI 48239-2609
(248) 579-3981
Mailing address
12956 LENORE, REDFORD, MI 48239-2609
(248) 579-3981
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362009770
MI
Other
Enumeration date
08/15/2023
Last updated
03/25/2026
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