Individual
JESSICA DOMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2200 FORT ROOTS DR # 116B, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-3481
Mailing address
2500 LEESTOWN RD, 116B, LEXINGTON, KY 40511-1052
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY.0004502
CO
Other
Enumeration date
09/01/2016
Last updated
07/20/2020
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