Clark, Dominique Jolie
Clark, Dominique Jolie is an sole proprietor health care provider with primary practice located at 12201 Wallace Landing Ct , Upper Marlboro MD 20772-7957. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Clark, Dominique Jolie can be contacted via phone (240) 417-9810.Contact Information
Primary practice address
12201 Wallace Landing Ct
Upper Marlboro MD 20772-7957
Phone: (240) 417-9810
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 146009176 | Illinois |
Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 22004686A | Indiana |
Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 05036 | Maryland |
Profile Details
NPI number | 1265678502 |
---|---|
LBN Legal business name | Clark, Dominique Jolie |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 16th, 2008 |
Last updated | Aug 3rd, 2018 - about 6 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.
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