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Contact Information

JESSICA DOMST, MA
393 NORTH ST
SPRINGVILLE, NY14141-9652
 Phone: 716-592-9331
 Fax: 716-592-4683
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

School

103TS0200X 62 Psychologist, Clinical
 

School

1041S0200X
Indicates primary specialty

NPI Profile & details for JESSICA DOMST · (Female)

NPI # 1215327416
Status Active
Credentials MA
Entity Individual
Enumeration date 01/27/2015
Last updated 01/27/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 146639021
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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