Individual
DOMINIQUE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1423 CHANDELLAY DR, SAINT LOUIS, MO 63146-4802
(314) 761-6162
Mailing address
1423 CHANDELLAY DR, SAINT LOUIS, MO 63146-4802
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2017026350
MO
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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