Most Relevant Information
Provider Data
| NPI Number: | 1003011453 |
| Provider Name: | SALLIE JANE DOMINEY |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/17/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
5 SW D AVE
SUITE 5
LAWTON
OK
735014619
Practice Location Phone/Fax
| Phone: | 5802501222 |
| Fax: | 5802501795 |
Provider Mailing Location
4436 NW 50TH ST
OKLAHOMA CITY
OK
731122212
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |