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General NPI Number Information
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NPI Number | 1083015713
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Entity Type | Individual
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Provider Name | DOMINIQUE MICHELLE BATTLE M.S., NCC, CFT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 11740 SW 68TH PKWY STE 200
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City | TIGARD
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State | OR
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Zip | 97223-9058
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Country | US
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Telephone | 541-252-7595
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Fax | 321-348-5786
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Provider Business Mailing Address
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Address Line | 877 W MINNEOLA AVE UNIT 120946
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City | CLERMONT
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State | FL
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Zip | 34712-7039
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Country | US
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Telephone | 407-951-4207
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Fax | 321-348-2861
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | R12124
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License Number State | OR
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