Individual
CAMILA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT
Contact information
Practice address
3802 DAMASCUS DR, SAINT JOSEPH, MO 64506-2091
(417) 529-0217
Mailing address
3802 DAMASCUS DR, SAINT JOSEPH, MO 64506-2091
(417) 529-0217
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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