Individual
DOMINIQUE M PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
911 COLLEGE ST STE 205, BOWLING GREEN, KY 42101-2183
(270) 551-2032
Mailing address
3024 BRENT GRAY TRCE, OWENSBORO, KY 42303-2717
(401) 787-5235
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
266782
KY
235Z00000X
Speech-Language Pathologist
5441
TN
Other
Enumeration date
07/18/2012
Last updated
01/11/2023
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