Individual
DOMINQUE ANDRIESE FICKLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
149 CEDAR HILL AVE, NYACK, NY 10960-2424
(917) 736-4507
Mailing address
149 CEDAR HILL AVE, NYACK, NY 10960-2424
(917) 736-4507
Taxonomy
Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
002676-01
NY
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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