DOMINIQUE PHUA

GRAND RAPIDS, MI
NPI1053784413
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI  3743369)
Enumeration Date2015-11-07
Last Update Date2015-11-07
Business Address
-- DOMINIQUE PHUA
1115 BALL AVE NE
GRAND RAPIDS, MI 49505-5904
Phone number: 616-459-7215
Mailing Address
-- DOMINIQUE PHUA
3249 HUNTINGTON WOODS DR SE APT F
KENTWOOD, MI 49512-8128
Phone number:
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