Individual
DOMINIQUE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10312 HORTON DR, COLORADO SPRINGS, CO 80925-1473
(703) 498-7761
Mailing address
10312 HORTON DR, COLORADO SPRINGS, CO 80925-1473
(703) 498-7761
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CSW.09927093
CO
101YM0800X
Mental Health Counselor
LSW.0009922120
CO
Other
Enumeration date
01/19/2019
Last updated
05/31/2023
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