Individual
JENNIFER DOMINGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1051 NE 138TH ST, NORTH MIAMI, FL 33161-3823
(305) 494-9999
Mailing address
1051 NE 138TH ST, NORTH MIAMI, FL 33161-3823
(305) 494-9999
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11019511
FL
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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