Individual
KATHLEEN DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2626 CHARLES DR, SUITE 211, CHALMETTE, LA 70043-3779
(504) 278-4006
(504) 278-4007
Mailing address
2626 CHARLES DR., SUITE 211 PO BOX 1604, CHALMETTE, LA 70044
(504) 278-4006
(504) 278-4007
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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