Most Relevant Information
Provider Data
| NPI Number: | 1003354127 |
| Provider Name: | KENDRIC DOMINICK |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/09/2017 |
| Last Updated: | 02/09/2017 |
Provider Practice Location
5447 W SUNSET HILL AVE
BATON ROUGE
LA
708053215
Practice Location Phone/Fax
| Phone: | 3188402574 |
| Fax: |
Provider Mailing Location
5447 W. SUNSET HILL
BATON ROUGE
LA
70805
Provider Mailing Phone/Fax
| Phone: | 3188402574 |
| Fax: |