Individual
ALICIA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1145 M ST, GERING, NE 69341-2835
(308) 633-3703
Mailing address
1513 11TH AVE, SCOTTSBLUFF, NE 69361-2611
(308) 765-8971
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13742
NE
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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