Individual
CAROLYN DOMONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 VETERANS DR, MANTENO, IL 60950-9466
(815) 907-3540
Mailing address
1 VETERANS DR, MANTENO, IL 60950-9466
(815) 907-3540
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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