DOMINIQUE WILSON (NPI# 1750867511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750867511 |
| Entity Type | Individual |
| Full Name | DOMINIQUE WILSON |
| Practice Address |
1017 Fayetteville Rd Se # B Atlanta GA 30316-2932 |
| Practice Telephone | 4044869034 |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407345192 | Dominique Marie Wilson | Counselor | 785 Wall St # 200, O Fallon, IL 62269-1959 | 2018-05-08 |
| 1831478023 | Dominique Lashan Wilson | Counselor | 1099 S Broadway, Ste. 260 and 280, Lexington, KY 40504-3030 | 2011-08-05 |
| 1518567874 | Dominique Wilson | Midwife | 14961 W Bell Rd Ste 175, Surprise, AZ 85374-3220 | 2020-10-27 |
| 1467081109 | Dominique Wilson | Occupational Therapist | 14906 Jefferson Davis Hwy, Woodbridge, VA 22191-4016 | 2020-04-04 |
| 1225502065 | Dominique Wilson | Physical Therapist | 14405 Laurel Pl Ste 102, Laurel, MD 20707-6102 | 2019-01-15 |
| 1295019909 | Dominique Renee Wilson | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2011-09-30 |
| Street Address |
1017 FAYETTEVILLE RD SE # B |
| City | ATLANTA |
| State | GA |
| Zip Code | 30316-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609362920 | Jenifer Willenzik | Counselor | 1017 Fayetteville Rd Se # B, Atlanta, GA 30316-2932 | 2018-07-10 |
| 1235760547 | Dharma Davis | Counselor | 1017 Fayetteville Rd Se # B, Atlanta, GA 30316-2932 | 2020-01-27 |
| 1275004830 | Marian Kathryn Freeman | Counselor | 1017 Fayetteville Rd Se # B, Atlanta, GA 30316-2932 | 2018-12-07 |
| 1699254458 | Mary Elizabeth Winchester | Social Worker | 1017 Fayetteville Rd Se # B, Atlanta, GA 30316-2932 | 2018-08-12 |
| 1447736038 | Malavika Pai | Counselor | 1017 Fayetteville Rd Se # B, Atlanta, GA 30316-2932 | 2018-07-17 |
| 1184100349 | Taylor Roddie | Counselor | 1017 Fayetteville Rd Se # B, Atlanta, GA 30316-2932 | 2018-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156923 | Rakiya Williams | Counselor | 1030 Fayetteville Rd., Atlanta, GA 30316 | 2019-10-23 |
| 1215585815 | Madison Victoria Baugh | Counselor | Chris180, 1030 Fayetteville Rd, Atlanta, GA 30316 | 2019-08-28 |
| 1265089460 | Josee Dominque Muldrew | Counselor | 1030 Fayetteville Rd. Se, Atlanta, GA 30316 | 2019-08-22 |
| 1255984241 | Monique Overstreet | Counselor | 1030 Fayetteville Road, Atlanta, GA 30316 | 2019-07-19 |
| 1023573979 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 905 Memorial Drive Se, Atlanta-fulton, GA 30316 | 2019-02-05 |
| 1740726454 | Jimmy Brian Sambula | Behavior Technician | 1017 Fayetteville Rd. Se, Atlanta, GA 30316 | 2017-01-19 |
| 1033665039 | Liberty Group Senior Services | Clinic/Center | 1879 Glenwood Avenue, Atlanta, GA 30316 | 2016-08-30 |
| 1043673650 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 800 Glenwood Ave Se, Atlanta, GA 30316 | 2016-03-31 |
| 1992143382 | Ayodele Osasona | Surgery | 2004 Oak Terrace Dr Se, Atlanta, GA 30316 | 2013-06-07 |
| 1891945721 | Denise Renee Cagle | Social Worker | 1471 Town Country Dr Se, Atlanta, GA 30316 | 2008-09-28 |
| Find all providers in zip 30316 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487075040 | Wynter Bryant | Developmental Therapist | 3607 Uppark Dr, Atlanta, GA 30349-8733 | 2013-12-30 |
| 1790048197 | Alyssa Rouse | Developmental Therapist | 20 Marietta St Nw Apt 5b, Atlanta, GA 30303-2822 | 2012-06-20 |
| 1396902664 | Nancy Anne Wrage | Developmental Therapist | 2324 1250th Ave, Atlanta, IL 61723-9336 | 2008-05-22 |
| 1003469339 | Positive Differences Aba | Developmental Therapist | 1100 Peachtree St Ne Ste 200, Atlanta, GA 30309-4829 | 2019-07-16 |
| 1912412610 | Denaya Robbins | Developmental Therapist | 115 Perimeter Center Pl Ne, Atlanta, GA 30346 | 2017-12-05 |
| 1275076317 | Gjafreone Alysandra Nicole Onidas-gibson | Developmental Therapist | 260 Peachtree St Nw, Suite 2200, Atlanta, GA 30303-1202 | 2016-11-21 |
| 1609325893 | Ronnieka Key | Developmental Therapist | 260 Peachtree St Nw Ste 2200, Atlanta, GA 30303-1292 | 2016-09-28 |
| 1720537194 | Lehel Somogyi | Developmental Therapist | 260 Peachtree St Nw, Suite 2200, Atlanta, GA 30303-1202 | 2016-09-27 |
| 1992254304 | Taylor Kristan | Developmental Therapist | 260 Peachtree St Nw Ste 2200, Atlanta, GA 30303-1292 | 2016-09-27 |
| 1881142800 | Sydney Smith | Developmental Therapist | 260 Peachtree St Nw, Suite 2200, Atlanta, GA 30303-1202 | 2016-09-19 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.