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Individual

DOMINIQUE KEENAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RADT-I

Contact information

Practice address
1550 JULIESSE AVE, SACRAMENTO, CA 95815-1803
(916) 921-6598
(916) 921-6604
Mailing address
1550 JULIESSE AVENUE, SACRAMENTO, CA 95815
(916) 921-6598
(916) 921-6604

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
10/12/2016
Last updated
10/12/2016
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