Individual
DOMAZ WELLINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11414 W PARK PL, MILWAUKEE, WI 53224-3500
(262) 297-6680
(262) 364-2742
Mailing address
11414 W PARK PL, MILWAUKEE, WI 53224-3500
(262) 297-6680
(262) 364-2742
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5031-125
WI
106H00000X
Marriage & Family Therapist
354-228
WI
225C00000X
Rehabilitation Counselor
00041336
WI
Other
Enumeration date
07/30/2014
Last updated
12/01/2023
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