Individual
MRS. DOMINIQUE DELELLES JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD-CCC-SLP
Contact information
Practice address
505 N LA BREA AVE, LOS ANGELES, CA 90036-2015
(323) 937-4860
Mailing address
930 N CATALINA ST, BURBANK, CA 91505-2605
(323) 500-3907
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
16296
CA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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