Individual
JACQUELINE DOMPEREH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5680 KING CENTRE DR STE 600, ALEXANDRIA, VA 22315-5755
(703) 647-3826
(703) 546-0840
Mailing address
5680 KING CENTRE DR STE 600, ALEXANDRIA, VA 22315-5755
(703) 647-3826
(703) 546-0840
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
174H00000X
Health Educator
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2018
Last updated
04/08/2018
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