Individual
KIERRA DOMINGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
219 N 25TH ST, BATON ROUGE, LA 70806-3654
(225) 361-6637
Mailing address
219 N 25TH ST, BATON ROUGE, LA 70806-3654
(225) 361-6637
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
LA
Enumeration date
08/02/2018
Last updated
01/12/2024
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