Individual
LESLIE M DEDOMINIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2683 PALMER ST STE B, MISSOULA, MT 59808-1757
(406) 214-3131
Mailing address
2683 PALMER ST STE B, MISSOULA, MT 59808-1757
(406) 214-3131
(406) 213-1913
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22261
CA
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-LIC-14683
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57857
CALIFORNIA CHILDREN'S SERVICES
CA
Enumeration date
08/18/2015
Last updated
05/29/2026
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