Provider Demographics
NPI:1699429548
Name:GREER, DOMINIQUE (LAMFT)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:GREER
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5912 BEARD AVE S
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55410-2710
Mailing Address - Country:US
Mailing Address - Phone:612-386-7636
Mailing Address - Fax:
Practice Address - Street 1:5007 EXCELSIOR BLVD STE 132
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3013
Practice Address - Country:US
Practice Address - Phone:612-386-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist