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1225766504
DOMINIQUE C SOUTHERS
CHARLOTTE, NC
NPI
1225766504
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-08-12
Last Update Date
2022-08-12
Business Address
DOMINIQUE C SOUTHERS
1401 E 7TH ST
CHARLOTTE, NC 28204-6300
Phone number: 704-780-4271
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Mailing Address
DOMINIQUE C SOUTHERS
1401 E 7TH ST
CHARLOTTE, NC 28204-6300
Phone number: 704-780-4271
Copy
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