Individual
DOMINIQUE FARMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 ALFRED ST APT 511, BRIDGEPORT, CT 06605-2982
(860) 680-3146
Mailing address
215 ALFRED ST APT 511, BRIDGEPORT, CT 06605-2982
(860) 680-3146
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/30/2022
Last updated
12/30/2022
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