Kelly Dominic, Imft Llc | |
10955 Clearport Rd Sw Amanda OH 43102-9612 | |
(330) 730-9511 | |
Not Available |
Full Name | Kelly Dominic, Imft Llc |
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Speciality | Community/behavioral Health |
Location | 10955 Clearport Rd Sw, Amanda, Ohio |
Authorized Official Name and Position | Kelly M Dominic (MARRIAGE AND FAMILY THERAPIST OWNER) |
Authorized Official Contact | 3307309511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Kelly Dominic, Imft Llc 10955 Clearport Rd Sw Amanda OH 43102-9612 Ph: (330) 730-9511 | Kelly Dominic, Imft Llc 10955 Clearport Rd Sw Amanda OH 43102-9612 Ph: (330) 730-9511 |
NPI Number | 1811698657 |
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Provider Enumeration Date | 03/16/2023 |
Last Update Date | 03/16/2023 |
Certification Date | 03/16/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811698657 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |