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General NPI Number Information
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NPI Number | 1942040084
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Entity Type | Individual
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Provider Name | DOMINQUE MARIE NORMAN DSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1 CHILDRENS WAY # 401
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-6547
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Fax |
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Provider Business Mailing Address
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Address Line | 29 GRAND STAND DR
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City | AUSTIN
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State | AR
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Zip | 72007-8124
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Country | US
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Telephone | 716-697-8349
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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 | 8941-C
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License Number State | AR
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