Wilson, Dominique
Wilson, Dominique is an sole proprietor health care provider with primary practice located at 11185 Lake Blvd Ste 205 , Chisago City MN 55013-9814. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wilson, Dominique can be contacted via phone (952) 228-3487.Contact Information
Primary practice address
11185 Lake Blvd Ste 205
Chisago City MN 55013-9814
Phone: (952) 228-3487
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X |
Profile Details
| NPI number | 1083369490 |
|---|---|
| LBN Legal business name | Wilson, Dominique |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2022 |
| Last updated | Feb 14th, 2022 - about 3 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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