Individual
JENNA MICHELE DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
312 AMBOY AVE STE 2, METUCHEN, NJ 08840-2455
(732) 902-2181
Mailing address
312 AMBOY AVE STE 2, METUCHEN, NJ 08840-2455
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
37PC00853000
NJ
Other
Enumeration date
11/06/2021
Last updated
06/28/2022
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