Individual
DR. DOMONIQUE RICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IMFT-S
Contact information
Practice address
1491 POLARIS PKWY STE 216, COLUMBUS, OH 43240-2041
(614) 568-1258
Mailing address
1491 POLARIS PKWY STE 216, COLUMBUS, OH 43240-2041
(614) 568-1258
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0717001625
VA
106H00000X
Marriage & Family Therapist
Primary
F.1800041-SUPV
OH
106H00000X
Marriage & Family Therapist
M.1100005
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790062321
—
OH
Enumeration date
11/10/2011
Last updated
09/05/2024
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