Individual
MS. DOMINIQUE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CRC
Contact information
Practice address
1809 AGGIE RD, JONESBORO, AR 72401
(870) 316-3075
Mailing address
PO BOX 292, STATE UNIVERSITY, AR 72467-0292
(870) 316-3075
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P2107003
AR
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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