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Individual

MS. AIMEE D. DOMINIQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
143 RIDGEWAY DR, SUITE 207, LAFAYETTE, LA 70503-3414
(337) 257-0883
Mailing address
305 RAYWOOD DR, LAFAYETTE, LA 70503-5057
(337) 257-0883

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2895
LA

Other

Enumeration date
03/21/2006
Last updated
12/03/2008
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