Individual
DOMINIQUE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1685 BALDWIN AVE STE 100, PONTIAC, MI 48340-1242
(248) 706-3450
Mailing address
7334 FAUST AVE, DETROIT, MI 48228-5412
(313) 296-6655
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/20/2023
Last updated
04/20/2023
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