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Individual

DOMINIQUE BONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
604 1/2 HIGH ST STE 100, PORTSMOUTH, VA 23704-3437
(757) 724-5254
Mailing address
317 DECLARATION LN, SUFFOLK, VA 23434-2370
(757) 724-5254

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701011657
VA

Other

Enumeration date
09/16/2022
Last updated
09/09/2024
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