DOMINIQUE PHUA NPI 1053784413

NPI Information

NPI: 1053784413
Provider Name: DOMINIQUE PHUA
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1115 BALL AVE NE
GRAND RAPIDS, MI
ZIP 49505
Phone: (616) 459-7215
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Dominique Phua is an addiction (substance use disorder) counselor in Grand Rapids, MI. Dominique Phua NPI is 1053784413. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1115 BALL AVE NE
GRAND RAPIDS, MI
ZIP 49505-904
Phone: (616) 459-7215

The enumeration date for this NPI number is 11/7/2015 and was last updated on 11/7/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	3743369	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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