Individual
DANIELLE DOMASKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1341 N ESCONDIDO BLVD, ESCONDIDO, CA 92026-2507
(760) 317-9121
Mailing address
1341 N ESCONDIDO BLVD, ESCONDIDO, CA 92026-2507
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/23/2017
Last updated
02/23/2017
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