Individual
ANDREA ROSELYN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 N EUCLID AVE, ONTARIO, CA 91762-2729
(909) 983-2020
Mailing address
3943 TOPAZ LN, LA VERNE, CA 91750-2672
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
14170
CA
106H00000X
Marriage & Family Therapist
Primary
140416
CA
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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