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Individual

RITA GENOVEVA DOMINGUEZ ROMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CHW2

Contact information

Practice address
6285 ANGORA PEAK LN, LAS VEGAS, NV 89115-1662
(954) 860-3216
Mailing address
6285 ANGORA PEAK LN, LAS VEGAS, NV 89115-1662
(954) 860-3216

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
NV
172V00000X
Community Health Worker
Primary
207Q00000X
NV
172V00000X
Community Health Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
193200000X
MULTI SPECIALTY-GROUP
NV
Enumeration date
09/06/2023
Last updated
12/05/2025
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