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1053073189
DOMINIQUE WILLOCK
MCDONOUGH, GA
NPI
1053073189
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-10-06
Last Update Date
2021-10-06
Business Address
DOMINIQUE WILLOCK
1624 BENNETT DR
MCDONOUGH, GA 30253-9010
Phone number: 516-808-0591
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Mailing Address
DOMINIQUE WILLOCK
1624 BENNETT DR
MCDONOUGH, GA 30253-9010
Phone number: 516-808-0591
Copy
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