Provider Demographics
NPI:1003511346
Name:TOWNS, DOMINIQUE L (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DOMINIQUE
Middle Name:L
Last Name:TOWNS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36088 W SAN CLEMENTE AVE
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-2117
Mailing Address - Country:US
Mailing Address - Phone:414-731-5267
Mailing Address - Fax:
Practice Address - Street 1:36088 W SAN CLEMENTE AVE
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-2117
Practice Address - Country:US
Practice Address - Phone:414-731-5267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty