Individual
CARLAH DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
670 ROUTE 1 N, ISELIN, NJ 08830-2629
(732) 510-1140
(732) 218-9749
Mailing address
2701 RENAISSANCE BLVD FL 4, KING OF PRUSSIA, PA 19406-2781
(484) 803-9663
(484) 393-4096
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00320100
NJ
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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