Individual
MRS. DOMINIQUE DIJKHUIZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
101 LANARK TRL, SOUTHERN PINES, NC 28387-7513
(719) 270-1722
Mailing address
216 COMMERCE AVE # 189, SOUTHERN PINES, NC 28387-7059
(719) 270-1722
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1689148397
CO
Other
Enumeration date
01/15/2019
Last updated
06/06/2022
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