Individual
DOMINIQUE SYDNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1217 SPRING GARDEN ST FL 1, PHILADELPHIA, PA 19123-3225
(215) 769-3561
(215) 769-3860
Mailing address
1217 SPRING GARDEN ST FL 1, PHILADELPHIA, PA 19123-3225
(215) 769-3561
(215) 769-3860
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024869940001
—
PA
Enumeration date
08/11/2014
Last updated
08/11/2014
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