Provider Demographics
NPI:1982295838
Name:DOMMER, NEDDY PAULINE (LMFT)
Entity type:Individual
Prefix:
First Name:NEDDY
Middle Name:PAULINE
Last Name:DOMMER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5646 MILTON ST STE 330
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3931
Mailing Address - Country:US
Mailing Address - Phone:214-253-9207
Mailing Address - Fax:
Practice Address - Street 1:5646 MILTON ST STE 330
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-3931
Practice Address - Country:US
Practice Address - Phone:214-253-9207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty