Individual
KELLY JEANNE DOMINIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1114 BENFIELD BLVD STE G, MILLERSVILLE, MD 21108-2589
(443) 386-4928
Mailing address
1114 BENFIELD BLVD STE G, MILLERSVILLE, MD 21108-2589
(443) 386-4928
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC3062
MD
Other
Enumeration date
09/30/2016
Last updated
02/17/2026
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