Individual
DOMINIQUE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1170 N ESTRELLA PKWY STE A107, GOODYEAR, AZ 85338-9276
(623) 263-0105
(623) 292-8825
Mailing address
1170 N ESTRELLA PKWY STE A107, GOODYEAR, AZ 85338-9276
(623) 263-0105
(623) 292-8825
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
250020
AZ
176B00000X
Midwife
—
—
Other
Enumeration date
10/27/2020
Last updated
03/18/2024
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