Individual
ALICIA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5201 VENICE AVE NE STE A, ALBUQUERQUE, NM 87113-2337
(505) 916-2007
Mailing address
941 LOMA PINON LOOP NE, RIO RANCHO, NM 87144-0590
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/13/2021
Last updated
06/13/2021
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