Individual
TERRY DOMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW, MLA
Contact information
Practice address
4300 S I 10 SERVICE RD W STE 215, METAIRIE, LA 70001-7436
(504) 301-9990
(504) 301-9990
Mailing address
4300 S I 10 SERVICE RD W STE 215, METAIRIE, LA 70001-7436
(504) 301-9990
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13761
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13761
CSW
LA
Enumeration date
09/05/2017
Last updated
09/05/2017
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