Individual
SANDRA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1600 THORPE RD, LAS CRUCES, NM 88012-9776
(575) 382-9292
(575) 382-2061
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-07173
NM
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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