Provider Demographics
NPI:1245895531
Name:PLANTE, DOMINIQUE CATHERINE (MA CCC SLP TSSLD)
Entity type:Individual
Prefix:MRS
First Name:DOMINIQUE
Middle Name:CATHERINE
Last Name:PLANTE
Suffix:
Gender:F
Credentials:MA CCC SLP TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SWAN LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-4437
Mailing Address - Country:US
Mailing Address - Phone:516-503-4171
Mailing Address - Fax:
Practice Address - Street 1:678 CANTIAGUE ROCK RD
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1401
Practice Address - Country:US
Practice Address - Phone:516-203-3650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027988-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty