Individual
ALEXIA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 BERTHA RD STE B, TAOS, NM 87571-7148
(575) 779-9423
Mailing address
528 1/2 DOLORES RD., RANCHOS DE TAOS, NM 87557
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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