Phua, Dominique
Phua, Dominique is an sole proprietor health care provider with primary practice located at 1115 Ball Ave Ne , Grand Rapids MI 49505-5904. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Phua, Dominique can be contacted via phone (616) 459-7215.Contact Information
Primary practice address
1115 Ball Ave Ne
Grand Rapids MI 49505-5904
Phone: (616) 459-7215
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 3743369 | Michigan |
Profile Details
| NPI number | 1053784413 |
|---|---|
| LBN Legal business name | Phua, Dominique |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 7th, 2015 |
| Last updated | Nov 7th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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