Dominique Dominguez
Counselor, Mental Health in Philadelphia, PA. Individual provider (NPI-1).
NPI number1083171862
StatusActive
Last updated in NPPESFeb 27, 2019
Details
- NPI
- 1083171862
- Entity type
- Individual (NPI-1)
- Name
- Dominique Dominguez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 27, 2019
- Last updated
- Feb 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
5043 Frankford AvePhiladelphia, PA 19124-2644
Phone 215-744-4343
Mailing address
12203 Barbary RdPhiladelphia, PA 19154-1801
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