Individual
DOMINIQUE LAURAE THURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5939 WOODCREST AVE, PHILADELPHIA, PA 19131-2216
(215) 873-3399
Mailing address
5939 WOODCREST AVE, PHILADELPHIA, PA 19131-2216
(215) 873-3399
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF001724
PA
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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