Individual
DOMINIQUE DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 LEE ROAD 279, SALEM, AL 36874-4776
(706) 617-4315
Mailing address
3000 LEE ROAD 279, SALEM, AL 36874-4776
(706) 617-4315
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC012370
GA
Other
Enumeration date
01/21/2016
Last updated
02/14/2023
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