Domonique Blackmon's National Provider Identifier (NPI) Details
Domonique Blackmon, M.S., LPCA
NPI: 1770963597
Enumeration Date: 2015-06-06
Last updated: 2015-06-06
Sole Proprietor: NO
Status: active
Postal Address: 2816 VANSTORY ST, GREENSBORO, NC
Phone: 757-214-2423
Primary Practice Address: 1708 TRAWICK RD, SUITE 101, RALEIGH, NC
Practice's phone: 919-896-7536