Individual
DR. DOMINIQUE DELALOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3900 WOODLAND AVENUE, PHILADELPHIA VETERANS AFFAIRS MEDI, PHILADELPHIA, PA 19104
(205) 332-9129
Mailing address
110 RECOVERY RD, BAINBRIDGE, GA 39819-6209
(205) 332-9129
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
68019607
NY
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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