Doctor Name: | MS. BARBARA DOMINIC |
NPI Number: | 1629183892 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 0904002192 |
Business Practice Address: | 165 Old Kings Highway Orleans, MA - 02653 |
Business Phone Number: | 5082479506 |
Business Fax Number: | |
Mailing Address: | 250 S Eastham St, EASTHAM |
State: | MA |
Postal Code: | 026422656 |
Phone Number: | 5082479506 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904002192 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |