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NPI Profile for JESSICA DOMKE in BRIDGETON, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Art Therapist |
221700000X |
| NPI Number | 1083575989 |
|
| Status | Active | |
| Credentials | LPC, ATR | |
| Entity | Individual | |
| Enumeration date | 11/20/2025 | |
| Last updated | 11/20/2025 - About 7 months ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JESSICA DOMKE
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JESSICA DOMKE, LPC, ATR