| Doctor Name: | MRS. SARA DOMINICUS |
| NPI Number: | 1447483243 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW-CC |
| License Number: | LC13265 |
| Business Practice Address: | 25 Hospital Dr Bridgton, ME - 040091167 |
| Business Phone Number: | 2076472311 |
| Business Fax Number: | 2076476015 |
| Mailing Address: | 25 Hospital Dr, BRIDGTON |
| State: | ME |
| Postal Code: | 040091167 |
| Phone Number: | 2076472311 |
| Fax Number: | 2076476015 |
| NPI Enumeration Date: | 08/26/2009 |
| NPI Last Update Date: | 10/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LC13265 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |