Individual
DOMINIQUE RACHAEL EDOUARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-A
Contact information
Practice address
175 W FRANKLIN BLVD, GASTONIA, NC 28052-4145
(704) 865-3525
Mailing address
PO BOX 4003, GASTONIA, NC 28054-0041
(704) 865-3525
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P012588
NC
Other
Enumeration date
06/16/2018
Last updated
04/03/2019
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