Dominique, Kristine
Dominique, Kristine is an individual health care provider with primary practice located at 4705 Old Post Rd , Charlestown RI 02813-1819. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dominique, Kristine can be contacted via phone (401) 364-7705.Contact Information
Primary practice address
4705 Old Post Rd
Charlestown RI 02813-1819
Phone: (401) 364-7705
Fax: (401) 364-9104
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ISW01753 | Rhode Island |
Profile Details
| NPI number | 1386706521 |
|---|---|
| LBN Legal business name | Dominique, Kristine |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386706521 | NPPES |
| Rhode Island | MEDICAID | KD50510 |
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