Individual
CHESY DOMINGUEZ DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14713 SW 177TH TER, MIAMI, FL 33187-6762
(786) 312-7175
Mailing address
14713 SW 177TH TER, MIAMI, FL 33187-6762
(786) 312-7175
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-23-14862
FL
106S00000X
Behavior Technician
RBT1850806
FL
Other
Enumeration date
02/07/2017
Last updated
11/13/2023
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