Individual
DOMINIQUE SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5342 S WELLS ST, CHICAGO, IL 60609-6219
(708) 631-1929
Mailing address
5342 S WELLS ST, CHICAGO, IL 60609-6219
(708) 631-1929
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/27/2020
Last updated
09/27/2020
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