Individual
DOMINIQUE BASTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 RIVER ST, BOSTON, MA 02126-2729
(857) 574-0418
Mailing address
23 MINNESOTA AVE, SOMERVILLE, MA 02145-2113
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/29/2013
Last updated
03/29/2013
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