Aimee D. Dominique | Lafayette, LA • PECOS Search

Aimee D. Dominique

Social Worker

Behavioral Health & Social Service Providers

143 Ridgeway Dr, Suite 207, Lafayette, LA 70503-3414

PECOS Enrollment

Based on the most recent information from CMS, provider Aimee D. Dominique does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1992764799
Provider Type
Individual
Full Name
Dominique, Aimee D.
Title
Ms.
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
3/21/2006
Last Updated
12/3/2008

Contact Information

Practice Location

143 Ridgeway Dr, Suite 207, Lafayette, LA 70503-3414

Unlisted Fax

Mailing Location

305 Raywood Dr, Lafayette, LA 70503-5057

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 2895 Louisiana