| NPI | 1265980304 |
|---|---|
| Former Name | DOMINIQUE NICOLE HARDAWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: MD 0119007097) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2023-10-22 |