Provider Demographics
NPI:1043023450
Name:MCPEEK-GARWITZ, DOMINIQUE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:MCPEEK-GARWITZ
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 ALBERT RASCHE DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-2302
Mailing Address - Country:US
Mailing Address - Phone:217-329-5958
Mailing Address - Fax:
Practice Address - Street 1:2504 ALBERT RASCHE DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-2302
Practice Address - Country:US
Practice Address - Phone:217-329-5958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst