Individual
MS. DOMINIQUE J ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36-35 BELL BLVD FL 3, SUITE 304, QUEENS, NY 11361
(347) 321-4094
Mailing address
996 ROYAL MARCO WAY, MARCO ISLAND, FL 34145
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
789651990
NY
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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