Individual
JESSICA L DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2560 E MAIN ST, REEDSBURG, WI 53959-9472
(608) 355-4103
Mailing address
PO BOX 454, WAUNAKEE, WI 53597-0454
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12792
WI
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/01/2022
Last updated
06/02/2026
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