Individual
TIFFANY ANN DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS SLPA
Contact information
Practice address
14201 W SUNRISE BLVD, SUITE 107, SUNRISE, FL 33323-3207
(954) 756-2818
(954) 514-1126
Mailing address
14201 W SUNRISE BLVD, SUITE 107, SUNRISE, FL 33323-3207
(954) 756-2818
(954) 514-1126
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
2355S0801X
Speech-Language Assistant
SI2496
FL
Other
Enumeration date
06/10/2016
Last updated
06/07/2022
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