Individual
DOMINIQUE SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
57 PROSPECT ST, NORTHAMPTON, MA 01060-2130
(413) 210-3724
Mailing address
57 PROSPECT ST, NORTHAMPTON, MA 01060-2130
(413) 210-3724
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
264709916
MA
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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