DOMINIQUEA EDMISTON

STATESVILLE, NC
NPI1619618212
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: AZ  20424)
Additional Taxonomies104100000X Social Worker
(Licence: AZ  18434)
Enumeration Date2022-04-06
Last Update Date2024-08-04
Business Address
DOMINIQUEA EDMISTON LCSW
806 PHILLIPS LN
STATESVILLE, NC 28625-4596
Phone number: 602-525-7997
Mailing Address
DOMINIQUEA EDMISTON LCSW
806 PHILLIPS LN
STATESVILLE, NC 28625-4596
Phone number: 602-525-7997