Clark, Dominique

Clark, Dominique is an individual health care provider with primary practice located at 1150 Graham Rd , Florissant MO 63031-8077. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Clark, Dominique can be contacted via phone (314) 250-8277.

Contact Information

Primary practice address
1150 Graham Rd Florissant MO 63031-8077
Phone: (314) 250-8277
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X

Profile Details

NPI number 1841934544
LBN Legal business name Clark, Dominique
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2022
Last updated Apr 27th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers