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General NPI Number Information
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NPI Number | 1629729207
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Entity Type | Individual
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Provider Name | DOMINIQUE WILLIAMS LLMSW
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Gender | Female
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 124 PEARL ST
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City | YPSILANTI
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State | MI
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Zip | 48197-2663
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Country | US
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Telephone | 248-581-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 321 DOLORES DR
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City | PLEASANT LAKE
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State | MI
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Zip | 49272-9762
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Country | US
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Telephone | 517-745-9092
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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