Individual
DOMINIQUE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 N WYMORE RD STE 230, MAITLAND, FL 32751-4253
(407) 647-4740
Mailing address
1192 ARONIMINIK DR, MOUNT DORA, FL 32757-8723
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 15301
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020557400
—
FL
Enumeration date
04/01/2017
Last updated
03/17/2018
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