Individual
MS. DOMINIQUE JANAE MINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2813 BENNER ST, PHILADELPHIA, PA 19149-3508
(267) 336-4269
Mailing address
2813 BENNER ST, PHILADELPHIA, PA 19149-3508
(267) 336-4269
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW136876
PA
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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