Individual
DOMINIQUE RAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
460 BLOOMFIELD AVE STE OFFICE2, MONTCLAIR, NJ 07042-3582
(732) 674-9857
Mailing address
97 VIVANTE BLVD # 303, PUNTA GORDA, FL 33950-2025
(732) 674-9857
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00734200
—
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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