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Individual
MS. MARTHA DOMINGUEZ
Active
Individual
MS. MARTHA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1249
TX
106H00000X
Marriage & Family Therapist
3959
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00S18W
BXBS
TX
05
—
1164899-03
—
TX
Enumeration date
08/24/2006
Last updated
02/06/2025
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