Individual
DOMINIQUE DERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3708 LYCKAN PKWY STE 205, DURHAM, NC 27707-2586
(919) 514-3566
(919) 516-0057
Mailing address
3708 LYCKAN PKWY STE 205, DURHAM, NC 27707-2586
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P020696
NC
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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