Most Relevant Information
Provider Data
| NPI Number: | 1003682576 |
| Provider Name: | DOMINIQUE LARKIN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/27/2023 |
| Last Updated: | 11/27/2023 |
Provider Practice Location
5500 MURRELL RD STE 100
MELBOURNE
FL
329406700
Practice Location Phone/Fax
| Phone: | 3214267759 |
| Fax: |
Provider Mailing Location
300 INTERNATIONAL PKWY STE 200
LAKE MARY
FL
327465028
Provider Mailing Phone/Fax
| Phone: | 8666100580 |
| Fax: |