Individual
DOMINIQUE SAGE ELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 S NOVELL PLACE, PROVO, UT 84606
(801) 830-2038
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/28/2019
Last updated
07/30/2025
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