Individual
ANGELICA DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
712 EGAN ST, BROOKLYN, NY 11239-2819
(347) 765-8934
Mailing address
15722 POWELLS COVE BLVD, WHITESTONE, NY 11357-1332
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
11/30/2022
Last updated
11/30/2022
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