Individual
MARCELLIS DOMINIQUE WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
8010 N ELMWOOD AVE, KANSAS CITY, MO 64119-8600
(816) 769-3845
Mailing address
4716 NE 67TH ST, KANSAS CITY, MO 64119-7872
(816) 769-3845
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2021035831
MO
101YS0200X
School Counselor
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427526466
—
MO
Enumeration date
08/12/2020
Last updated
12/07/2021
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