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General NPI Number Information
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NPI Number | 1760972517
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Entity Type | Organization
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Legal Business Name | DOMINICK SCALISE PHD LLC
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | 511 N MUR LEN RD STE A
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City | OLATHE
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State | KS
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Zip | 66062-1208
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Country | US
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Telephone | 816-360-9221
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Fax | 800-207-3579
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Provider Business Mailing Address
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Address Line | 15184 MONROVIA ST
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City | OVERLAND PARK
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State | KS
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Zip | 66221-2366
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Country | US
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Telephone | 573-680-1671
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DOMINICK SCALISE
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Credential | PHD
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Telephone | 816-360-9221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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