Individual
JACQUELINE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3527 W 111TH ST, INGLEWOOD, CA 90303-2232
(310) 946-3496
Mailing address
3527 W 111TH ST, INGLEWOOD, CA 90303-2232
(310) 946-3496
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
1762
CA
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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