Most Relevant Information
Provider Data
| NPI Number: | 1003597592 |
| Provider Name: | DOMINIQUA SHEKEVIA BERNARDINE LISW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 258052 |
Most Important Dates
| Enumeration Date: | 07/27/2023 |
| Last Updated: | 08/16/2024 |
Provider Practice Location
10200 ALLIANCE RD STE 150
BLUE ASH
OH
452424754
Practice Location Phone/Fax
| Phone: | 5138910650 |
| Fax: |
Provider Mailing Location
6136 S JEFFERSON ST
BURLINGTON
KY
410059689
Provider Mailing Phone/Fax
| Phone: | 7864240632 |
| Fax: |