Doctor Name: | DOMINIQUE ROUMAIN |
NPI Number: | 1144570078 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW |
License Number: | 149015452 |
Business Practice Address: | 14647 Greenwood Rd 206 Dolton, IL - 604191875 |
Business Phone Number: | 7738481263 |
Business Fax Number: | |
Mailing Address: | 14647 Greenwood Rd, 206 DOLTON |
State: | IL |
Postal Code: | 604191875 |
Phone Number: | 7738481263 |
Fax Number: | |
NPI Enumeration Date: | 09/18/2012 |
NPI Last Update Date: | 09/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149015452 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |