Individual
ISABELLE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1401 N ALAMEDA BLVD, LAS CRUCES, NM 88005-1725
(575) 496-0883
Mailing address
PO BOX 374, MESILLA, NM 88046-0374
(575) 496-0883
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0092151
NM
Other
Enumeration date
12/26/2013
Last updated
12/26/2013
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