Dominique Maree Mock, QMHA
Counselor, Mental Health in Pendleton, OR. Individual provider (NPI-1).
NPI number1982304242
StatusActive
Last updated in NPPESMar 6, 2023
Details
- NPI
- 1982304242
- Entity type
- Individual (NPI-1)
- Name
- Dominique Maree Mock
- Credential
- QMHA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 6, 2023
- Certification date
- Mar 6, 2023
- Last updated
- Mar 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
331 Se 2nd StPendleton, OR 97801-2224
Phone 541-276-6207 · Fax 541-274-5628
Mailing address
Po Box 469Heppner, OR 97836-0469
Phone 541-676-9161 · Fax 541-676-5662
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