| NPI | 1023646106 |
|---|---|
| Former Legal Business Name | DOMINICK SCALISE PHD LLC |
| Entity Type | Organization |
| Authorized Contact | DOMINICK SCALISE Owner/President 573-680-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |