Provider Demographics
NPI:1083015713
Name:BATTLE, DOMINIQUE MICHELLE (MS, NCC, CFT)
Entity Type:Individual
Prefix:MS
First Name:DOMINIQUE
Middle Name:MICHELLE
Last Name:BATTLE
Suffix:
Gender:F
Credentials:MS, NCC, CFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 W MINNEOLA AVE UNIT 120946
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34712-7039
Mailing Address - Country:US
Mailing Address - Phone:407-951-4207
Mailing Address - Fax:321-348-2861
Practice Address - Street 1:1964 HOWELL BRANCH RD STE 110
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1042
Practice Address - Country:US
Practice Address - Phone:407-951-4207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health