Individual
DEBRA L. DOMKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 310-6923
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 310-6923
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005613A
IN
Other
Enumeration date
04/17/2009
Last updated
04/17/2009
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