Individual
DR. DOMINIC WALTER YSIDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2700 BENSON RD, GARNER, NC 27529-9059
(984) 202-7700
Mailing address
508 FULTON ST, DURHAM, NC 27705-3875
(919) 286-0411
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6868
NC
Other
Enumeration date
03/30/2019
Last updated
10/28/2025
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