Individual
DOMINIQUE TIARA MURPHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
614 W WRIGHT ST, PENSACOLA, FL 32501-4757
(850) 356-0230
Mailing address
614 W WRIGHT ST, PENSACOLA, FL 32501-4757
(850) 291-0198
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
238019
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M610178948870
—
FL
Enumeration date
12/09/2021
Last updated
06/06/2022
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