Individual
MS. DOMINIQUE SHAUNTE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5300 ANGELES VISTA BLVD, LOS ANGELES, CA 90043-1648
(323) 295-4555
(323) 295-3021
Mailing address
5300 ANGELES VISTA BLVD, LOS ANGELES, CA 90043-1648
(323) 295-4555
(323) 295-3021
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
04/01/2013
Last updated
06/04/2014
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