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Individual

MISS KELLY RAE DOMINICI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1601 E FOURTH PLAIN BLVD # V3-SATP, VANCOUVER, WA 98661-3753
(503) 237-5296
Mailing address
3818 N PIONEER CANYON DR, RIDGEFIELD, WA 98642-8288

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker

Other

Enumeration date
10/05/2006
Last updated
12/20/2022
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