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Individual

MR. JON M DOMACHOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A., PLPC

Contact information

Practice address
1 UNIVERSITY BLVD, SAINT LOUIS, MO 63121-4400
(314) 516-7231
(314) 516-6624
Mailing address
1 UNIVERSITY BLVD, SAINT LOUIS, MO 63121-4400

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2011020016
MO

Other

Enumeration date
07/07/2011
Last updated
07/07/2011
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