person
Lisette C Domiteaux, PHD
Mental Health Counselor in Dallas, Texas
NPI 1265561005

Lisette C Domiteaux is a Mental Health Counselor based in Dallas, TX and is specialized in Mental Health. Lisette C Domiteaux practices in Dallas, TX and has the professional credentials of PHD. The NPI Number for Lisette C Domiteaux is 1265561005 and holds a License No. 8717 (Texas).

The current practice location address for Lisette C Domiteaux is 5925 Forest Lane, Dallas, TX and can be reached out via phone at 214-363-0277 and via fax at 214-352-5388.

Location: 5925 Forest Lane, Dallas, TX, 75230-8805
person
Provider Profile Details
NPI Number
1265561005
Provider Name
Lisette C Domiteaux
Credential
PHD
Provider Entity Type
Individual
Gender
Female
Address
5925 Forest Lane, Dallas, TX, 75230-8805
Phone Number
214-363-0277
Fax Number
214-352-5388
Provider Enumeration Date
03/05/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
752231883 01 TX FEDERAL TAX ID
institution
Provider Business Practice Location Address Details
Address
5925 Forest Lane
City
State
Zip
75230-8805
Phone Number
214-363-0277
Fax Number
214-352-5388
person
Provider Business Mailing Address Details
Address
5925 Forest Lane
City
State
Zip
75230-8805
Phone Number
214-363-0277
Fax Number
214-352-5388
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
8717 (Texas)
Definition
Definition to come...
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