Individual
DOMINIQUE BALDERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
W317S3439 STATE ROAD 83 APT B, WAUKESHA, WI 53189-9428
(414) 759-5247
Mailing address
W317S3439 STATE ROAD 83 APT B, WAUKESHA, WI 53189-9428
(414) 759-5247
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19426
WI
101YM0800X
Mental Health Counselor
Primary
11434125
WI
Other
Enumeration date
02/10/2022
Last updated
04/01/2025
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