Individual
DR. MARIA MERCEDES DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LMFT
Contact information
Practice address
124 ELLIS ST, FORT LEONARD WOOD, MO 65473-1148
(808) 600-4458
Mailing address
233 ILLINOIS AVE UNIT 752, FORT LEONARD WOOD, MO 65473-3232
(808) 600-4458
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101006781
MI
106H00000X
Marriage & Family Therapist
562
HI
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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