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General NPI Number Information
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NPI Number | 1043130990
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Entity Type | Organization
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Legal Business Name | SAFE SPACE 2B LLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 314 ARROWWOOD RD
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-6175
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Country | US
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Telephone | 337-371-2995
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Fax |
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Provider Business Mailing Address
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Address Line | 314 ARROWWOOD RD
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-6175
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. BRITTANY MICHELLE DOMINGUE
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Credential | PMHNP
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Telephone | 337-371-2995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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