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Individual

AIMEE VEGA DOMINGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1975 W 44TH PL APT 103, HIALEAH, FL 33012-8412
(786) 454-6627
Mailing address
1975 W 44TH PL APT 103, HIALEAH, FL 33012-8412
(786) 454-6627

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-98041
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104436400
FL
Enumeration date
12/13/2019
Last updated
02/09/2022
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