Individual
CAUSSAUNDRA MARIA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2772 S MARTIN LUTHER KING, FRESNO, CA 93706
(559) 265-4800
Mailing address
2772 S MARTIN LUTHER KING, FRESNO, CA 93706
(559) 265-4800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15271
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1362830919
CA
Other
Enumeration date
10/21/2019
Last updated
05/16/2024
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