Individual
DOMINIQUE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 ANATOLE DR, LAFAYETTE, LA 70508-8179
(347) 623-9237
Mailing address
957 BERGEN ST, BROOKLYN, NY 11216-2906
(347) 623-9237
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
096388
NY
104100000X
Social Worker
109518
TX
104100000X
Social Worker
16413
LA
1041C0700X
Clinical Social Worker
Primary
094693
NY
Other
Enumeration date
02/28/2022
Last updated
01/28/2023
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