Individual
MISS DOMINIQUE C DILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, MS
Contact information
Practice address
3812 MERIDIAN ST N, HUNTSVILLE, AL 35811-1118
(256) 631-5410
Mailing address
4212 IRONDALE DR NW, HUNTSVILLE, AL 35810
(256) 631-5410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3984
AL
101YM0800X
Mental Health Counselor
3984
AL
101YP2500X
Professional Counselor
Primary
3984
AL
102L00000X
Psychoanalyst
3984
AL
106H00000X
Marriage & Family Therapist
3984
AL
Other
Enumeration date
12/05/2018
Last updated
11/10/2021
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