DAD'S JASON DOMINIQUE

ENFIELD, CT
NPI1932480639
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2011-09-08
Last Update Date2011-09-08
Business Address
-- DAD'S JASON DOMINIQUE
153 HAZARD AVE
ENFIELD, CT 06082-4592
Phone number: 860-253-5020
Mailing Address
-- DAD'S JASON DOMINIQUE
995 DAY HILL RD
WINDSOR, CT 06095-1722
Phone number: 860-731-5522
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