Domonique Marie Dodge-Souza
Behavior Technician in Novi, MI. Individual provider (NPI-1).
NPI number1245001007
StatusActive
Last updated in NPPESJan 10, 2024
Details
- NPI
- 1245001007
- Entity type
- Individual (NPI-1)
- Name
- Domonique Marie Dodge-Souza
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 10, 2024
- Certification date
- Jan 10, 2024
- Last updated
- Jan 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
21600 Novi Rd Ste 800Novi, MI 48375-5608
Phone 248-305-6172 · Fax 248-697-2482
Mailing address
21600 Novi Rd Ste 800Novi, MI 48375-5608
Phone 248-305-6172 · Fax 248-697-2482
Other practice locations
16700 17 Mile Rd Ste A
Clinton Township, MI 48038-7325
Clinton Township, MI 48038-7325
Phone 586-228-2300 · Fax 586-228-2307
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