Dominczak, Geoffrey

Dominczak, Geoffrey is an individual health care provider with primary practice located at 2814 Woodcliff Cir Se , Grand Rapids MI 49506-3155. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Technologists, Technicians & Other Technical Service Providers / Technician, Other, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Dominczak, Geoffrey can be contacted via phone (616) 308-0323.

Contact Information

Primary practice address
2814 Woodcliff Cir Se Grand Rapids MI 49506-3155
Phone: (616) 308-0323
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1174068613
LBN Legal business name Dominczak, Geoffrey
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2016
Last updated Oct 30th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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