Individual
MIA RENEE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 E RUSSELL RD, LAS VEGAS, NV 89120-2426
(702) 848-1696
Mailing address
1575 W WARM SPRINGS RD UNIT 624, HENDERSON, NV 89014-3515
(775) 419-9432
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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