Dominique, Jerry

Dominique, Jerry is an individual health care provider with primary practice located at 787 Pleasant St , Henrico VA 23075-1235. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Dominique, Jerry can be contacted via phone (347) 742-7360.

Contact Information

Primary practice address
787 Pleasant St Henrico VA 23075-1235
Phone: (347) 742-7360
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1407256860
LBN Legal business name Dominique, Jerry
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2014
Last updated Sep 3rd, 2014 - about 10 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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