Individual
JONATHAN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 W 21ST ST, CONCORDIA, KS 66901-5200
(785) 243-8900
Mailing address
210 W 21ST ST, CONCORDIA, KS 66901-5200
(785) 243-8900
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC04302
KS
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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