Individual
JESSICA DOMNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(316) 268-8223
Mailing address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3356
—
KS
Enumeration date
01/10/2019
Last updated
01/10/2019
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