Individual
ITZEL DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4127 NW 122ND ST STE C, OKLAHOMA CITY, OK 73120-8880
(405) 455-6868
(405) 562-3444
Mailing address
1900 E 15TH ST STE 800B, EDMOND, OK 73013-6682
(405) 455-6868
(405) 562-3444
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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