DOMINIQUEA EDMISTON, LCSW

Social Worker - Clinical

Active Individual
NPI: 1619618212

Practice Address

806 PHILLIPS LN
Statesville, NC 28625

Phone: (602) 525-7997

Specialties

Specialty Code Primary License
Social Worker 104100000X No 18434 (AZ)
Social Worker - Clinical 1041C0700X Yes 20424 (AZ)

Frequently Asked Questions

NPI 1619618212 is the National Provider Identifier for DOMINIQUEA EDMISTON, LCSW, a Social Worker - Clinical provider located in Statesville, NC. This NPI was enumerated on April 6, 2022.
DOMINIQUEA EDMISTON, LCSW practices at 806 PHILLIPS LN, Statesville, NC 28625.

Quick Facts

NPI
1619618212
Type
Individual
Enumerated
Apr 6, 2022
Last Updated
Aug 4, 2024

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