| NPI | 1669170734 |
|---|---|
| Former Name | DOMINIQUE PAGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851115725) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6851115725) |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2023-02-20 |