Individual
DOMONIQUE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3253 CONGRESS AVE, SAGINAW, MI 48602-3106
(989) 475-4171
(989) 393-6021
Mailing address
3253 CONGRESS AVE, SAGINAW, MI 48602-3106
(989) 475-4171
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
6401225006
MI
101YM0800X
Mental Health Counselor
6451022099
MI
101YP2500X
Professional Counselor
Primary
6401225006
MI
101YP2500X
Professional Counselor
6451022099
—
Other
Enumeration date
11/12/2021
Last updated
03/27/2025
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