Individual
RITA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 WEST WASHINGTON STREET, ANTHONY, NM 88021
(505) 882-6200
(505) 882-6280
Mailing address
P.O. DRAWER 70, ANTHONY, NM 88021
(575) 882-6101
(575) 882-6926
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
B-2391
NM
1041S0200X
School Social Worker
Primary
B2391
NM
Other
Enumeration date
08/23/2007
Last updated
01/08/2014
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