Individual
DOMINIQUE MARIE MENDANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
306 N MAIN ST STE 1A1, HINESVILLE, GA 31313-2533
(912) 320-4573
Mailing address
306 N MAIN ST STE 1A1, HINESVILLE, GA 31313-2533
(912) 320-4573
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ6967
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014102100
—
FL
Enumeration date
01/05/2015
Last updated
07/21/2022
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