Individual
MRS. RAQUEL DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14425 COUNTRY WALK DR, MIAMI, FL 33186-8103
(786) 349-4700
(786) 701-2635
Mailing address
13756 SW 149TH CIRCLE LN APT 4, MIAMI, FL 33186-5789
(305) 742-7911
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
RBT-20-122266
FL
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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