Individual
KRISTY DOMNANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
930 20TH ST S, SUITE 101, BIRMINGHAM, AL 35205-2610
(205) 934-5471
(205) 975-2380
Mailing address
1530 3RD AVE S, CH19-307, BIRMINGHAM, AL 35294-2041
(205) 934-5471
(205) 975-2380
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1719
AL
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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