Healthcare Provider Details

I. General information

NPI: 1245651082
Provider Name (Legal Business Name): MRS. DOMINIQUE VALERIE PIERCE-OCONNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOMINIQUE VALERIE PIERCE MSW

II. Dates (important events)

Enumeration Date: 12/20/2013
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 PRINCETON HIGHTSTOWN RD SUITE 202
PRINCETON JUNCTION NJ
08550-1100
US

IV. Provider business mailing address

88 PRINCETON HIGHTSTOWN RD SUITE 202
PRINCETON JUNCTION NJ
08550-1100
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL05708100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 7764
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: