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1144982893
DOMINIQUE IVORY
BATON ROUGE, LA
NPI
1144982893
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-10-11
Last Update Date
2021-10-11
Business Address
DOMINIQUE IVORY
11861 COURSEY BLVD
BATON ROUGE, LA 70816-4404
Phone number: 225-612-8656
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Mailing Address
DOMINIQUE IVORY
11861 COURSEY BLVD
BATON ROUGE, LA 70816-4404
Phone number: 225-612-8656
Copy
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